Organization
OCCUPATIONAL DEVELOPMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT JACKSON (PRESIDENT/CEO)
(309) 820-0723
Entity
Organization
Contact information
Practice address
360 WYLIE DR, NORMAL, IL 61761-5500
(309) 820-0723
Mailing address
360 WYLIE DR, NORMAL, IL 61761-5500
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
10/15/2007
Last updated
12/11/2007
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