Organization
SESSER VALIER CUD 196
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERA EUBANKS (ADMINISTRATIVE ASSISTANT)
(618) 625-6696
Entity
Organization
Contact information
Practice address
4626 STATE HIGHWAY 154, SESSER, IL 62884-2277
(618) 625-6696
Mailing address
4626 STATE HIGHWAY 154, SESSER, IL 62884-2277
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
261QS1000X
IL
Other
Enumeration date
03/06/2007
Last updated
08/22/2020
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