Shawnee Health Service and Development Corp

NPI #1053878967 in Carbondale, Illinois

Provider Information

NPI Number
1053878967
Entity Type
Organization
Organization Name
Shawnee Health Service and Development Corp
Subpart
Yes (part of a larger organization)
Parent Organization
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Primary Specialty
Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date
Feb 27, 2019
Last Updated
Jul 29, 2024

Practice Location

Address
1025 N WALL ST RM 102
ZIP Code
62901-1737
Phone
(618) 519-9200

Authorized Official

Name
CHRISTINA CARNEY
Title
CEO
Phone
(618) 956-9521

Specialties & Taxonomy Codes

Specialty
Counselor - Mental HealthMental Health
Social Worker - ClinicalClinical
Dentist - General PracticeGeneral Practice
Dental Hygienist
Clinic/Center - Federally Qualified Health Center (FQHC)Federally Qualified Health Center (FQHC)

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