Organization
PIONEER CONCEPTS INC
Active
Parent organization
PIONEER CONCEPTS INC
Other names
Prairie House
Organization subpart
Yes
Provider details
NPI number
Legal business name
PIONEER CONCEPTS INC
Authorized official
MR. RONALD J WILSON (AUTHORIZED AGENT)
(309) 343-1550
Entity
Organization
Contact information
Practice address
1770 SAUK TRAIL, SAUK VILLAGE, IL 60411-4956
(708) 757-6729
(708) 757-6974
Mailing address
285 SOUTH FARNHAM STREET, GALESBURG, IL 61401-5323
(309) 343-1550
(309) 343-6318
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
48025
IL
Other
Enumeration date
04/09/2008
Last updated
04/20/2008
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