Organization
MOULTRIE COUNTY BEACON, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN RAUCH (EXECUTIVE DIRECTOR)
(217) 728-7396
Entity
Organization
Contact information
Practice address
401 W WATER ST, SULLIVAN, IL 61951-1883
(217) 728-7396
(217) 728-2217
Mailing address
401 W WATER ST, SULLIVAN, IL 61951-1883
(217) 728-7396
(217) 728-2217
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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