Organization
SHAWNEE HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID M ROBERTS (CHIEF EXECUTIVE OFFICE)
(618) 262-7552
Entity
Organization
Contact information
Practice address
137 SOUTH DR, MOUNT CARMEL, IL 62863-2811
(618) 262-7205
Mailing address
137 SOUTH DR, MOUNT CARMEL, IL 62863-2811
(618) 262-7205
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
001
IL
Other
Enumeration date
07/04/2007
Last updated
07/21/2022
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