Healthcare Provider Details

I. General information

NPI: 1891156808
Provider Name (Legal Business Name): HANCOCK COUNTY SENIOR SERVICES ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2016
Last Update Date: 04/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 S ADAMS ST
CARTHAGE IL
62321-1600
US

IV. Provider business mailing address

PO BOX 160
CARTHAGE IL
62321-0160
US

V. Phone/Fax

Practice location:
  • Phone: 217-357-8566
  • Fax: 217-357-8564
Mailing address:
  • Phone: 217-357-8566
  • Fax: 217-357-8564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: ADA BAIR
Title or Position: CEO
Credential:
Phone: 217-357-8566