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General NPI Number Information
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NPI Number | 1235340951
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Entity Type | Organization
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Legal Business Name | MASON COUNTY
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 1002 E LAUREL AVE
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City | HAVANA
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State | IL
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Zip | 62644-6973
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Country | US
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Telephone | 309-543-2201
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Fax | 309-543-2063
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Provider Business Mailing Address
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Address Line | 1002 E. LAUREL AVE.
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City | HAVANA
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State | IL
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Zip | 62644
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PUBLIC HEALTH ADMINISTRATOR
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Name | MR. CURT JIBBEN
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Credential |
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Telephone | 309-222-0110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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