Organization
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Active
Parent organization
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Other names
Shawnee Health Care, OB/GYN SUD
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Authorized official
PATSY R JENSEN (CEO)
(618) 956-9508
Entity
Organization
Contact information
Practice address
101 S WALL ST, CARBONDALE, IL 62901-3021
(618) 519-9200
(618) 519-9404
Mailing address
PO BOX 577, 109 CALIFORNIA ST, CARTERVILLE, IL 62918-0577
(618) 519-9200
(618) 985-4635
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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