Healthcare Provider Details

I. General information

NPI: 1891823662
Provider Name (Legal Business Name): WASHINGTON COUNTY VOCATIONAL WORKSHOP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

781 E. HOLZHAUER DR.
NASHVILLE IL
62263-0273
US

IV. Provider business mailing address

781 E. HOLZHAUER DR. P.O. BOX 273
NASHVILLE IL
62263-0273
US

V. Phone/Fax

Practice location:
  • Phone: 618-327-4461
  • Fax: 618-327-4477
Mailing address:
  • Phone: 618-327-4461
  • Fax: 618-327-4477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number04145
License Number StateIL

VIII. Authorized Official

Name: MR. KEITH A. CURRAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 618-327-4461