Organization
SPRING LAKE CC DIST 606
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY MASEAR (DIRECTOR)
(309) 347-5167
Entity
Organization
Contact information
Practice address
13650 N MANITO RD, MANITO, IL 61546-8438
(309) 347-5167
Mailing address
13650 N MANITO RD, MANITO, IL 61546-8438
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
06/05/2007
Last updated
08/22/2020
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