Organization
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Active
Parent organization
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Other names
Shawnee Health Care, Carbondale SUD
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Authorized official
PATSY R JENSEN (CEO)
(618) 956-9508
Entity
Organization
Contact information
Practice address
400 S LEWIS LN, CARBONDALE, IL 62901-3547
(618) 519-9200
(618) 519-9961
Mailing address
PO BOX 577, 109 CALIFORNIA ST, CARTERVILLE, IL 62918-0577
(618) 519-9200
(618) 985-4635
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
09/24/2019
Last updated
09/24/2019
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