Organization
FAMILY SUPPORT & TRAINING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUANITA STANDIFER (CEO)
(217) 766-0492
Entity
Organization
Contact information
Practice address
1702 INTERSTATE DR, CHAMPAIGN, IL 61822-1068
(217) 766-0492
Mailing address
PO BOX 3486, CHAMPAIGN, IL 61826-3486
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
10/07/2008
Last updated
10/07/2008
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