T

NPI #1356707350 in Fairfield, Illinois

Provider Information

NPI Number
1356707350
Entity Type
Organization
Organization Name
T
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Jan 6, 2016
Last Updated
Jan 6, 2016

Practice Location

Address
813 W CENTER ST
ZIP Code
62837-1403
Phone
(618) 842-2260

Authorized Official

Name
TONYA LINDSEY
Title
PRESIDENT
Phone
(618) 244-7701

Specialties & Taxonomy Codes

Specialty
Intermediate Care Facility, Intellectual Disabilities

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