Organization
ST JOSEPH CCSD169
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD PENCE (SUPERINTENDENT)
(217) 469-2291
Entity
Organization
Contact information
Practice address
409 S 5TH ST, SAINT JOSEPH, IL 61873-9041
(217) 469-2291
(217) 469-8906
Mailing address
PO BOX 409, SAINT JOSEPH, IL 61873-0409
(217) 469-2291
(217) 469-8906
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/17/2007
Last updated
08/22/2020
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