Organization
LAND OF LINCOLN GOODWILL INDUSTRIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS MABERRY MA (VICE PRESIDENT OF VOCATIONAL REHAB)
(217) 494-7198
Entity
Organization
Contact information
Practice address
1220 OUTER PARK DR, SPRINGFIELD, IL 62704-4409
(217) 789-0400
Mailing address
1220 OUTER PARK DR, SPRINGFIELD, IL 62704-4409
(217) 789-0400
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
05/25/2016
Last updated
05/25/2016
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