Organization
GOLD PLATE PROGRAM OF PERRY COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY JEAN ASBURY (EXECUTIVE DIRECTOR)
(618) 542-3511
Entity
Organization
Contact information
Practice address
721 N HICKORY ST, DU QUOIN, IL 62832
(618) 542-3511
(618) 542-2566
Mailing address
PO BOX 345, DU QUOIN, IL 62832-0345
(618) 542-3511
(618) 542-2566
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/01/2018
Last updated
08/16/2018
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