Organization
PONTIAC-WM HOLLIDAY SD 105
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARRELL L SY (SUPERINTENDENT)
(618) 233-2320
Entity
Organization
Contact information
Practice address
400 ASHLAND AVE, FAIRVIEW HEIGHTS, IL 62208-2802
(618) 233-2320
(618) 233-0918
Mailing address
400 ASHLAND AVE, FAIRVIEW HEIGHTS, IL 62208-2802
(618) 233-2320
(618) 233-0918
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
02/05/2007
Last updated
08/22/2020
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