Organization
KREIDER SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY J STAUTER (EXECUTIVE DIRECTOR)
(815) 288-6691
Entity
Organization
Contact information
Practice address
605 N MAIN ST, STOCKTON, IL 61085-1121
(815) 947-2235
(815) 947-2026
Mailing address
PO BOX 366, DIXON, IL 61021-0366
(815) 288-6691
(815) 288-1636
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0047936
IL
Other
Enumeration date
04/09/2008
Last updated
08/19/2014
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