Organization
MOULTRIE COUNTY BEACON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA KATHY THOMAS LT 81590803 P (DEVELOPMENTAL THERAPIST)
(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
001
IL
Other
Enumeration date
01/28/2008
Last updated
07/21/2022
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