Organization
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.
Active
Other names
Swansea Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY MCCULLEY (CEO)
(618) 332-0694
Entity
Organization
Contact information
Practice address
3214 N ILLINOIS ST, SWANSEA, IL 62226-2330
(618) 233-0742
Mailing address
2041 GOOSE LAKE RD, SAUGET, IL 62206-2822
(618) 332-0953
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
IL
1041C0700X
Clinical Social Worker
—
IL
207Q00000X
Family Medicine Physician
—
IL
208000000X
Pediatrics Physician
—
IL
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
IL
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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