Shawnee Health Service & Development Corp
NPI #1174859870 in Carbondale, Illinois
Provider Information
- NPI Number
- 1174859870
- Entity Type
- Organization
- Organization Name
- Shawnee Health Service & 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
- Oct 30, 2009
- Last Updated
- Apr 4, 2024
Practice Location
- Address
- 402 S. LEWIS LANE
- City
- Carbondale
- State
- Illinois
- ZIP Code
- 62901
- Phone
- (618) 519-9901
Authorized Official
- Name
- CHRISTINA CARNEY
- Title
- CEO
- Phone
- (618) 956-9521
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
| Dental Hygienist |
| Dental Assistant |
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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