Organization
ST. LOUIS JC VAMC
Active
Other names
MARION VA CARE SITE
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN POTTER (NPI TEAM MEMBER)
(202) 382-2579
Entity
Organization
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(913) 578-4409
Mailing address
PO BOX 94462, CLEVELAND, OH 44101-4462
(913) 578-4409
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/29/2016
Last updated
01/17/2018
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