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General NPI Number Information
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NPI Number | 1548073208
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Entity Type | Organization
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Legal Business Name | S P I R I T CENTER NFP
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 12618 DAVIS RD
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City | WOODSTOCK
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State | IL
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Zip | 60098-9253
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Country | US
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Telephone | 815-861-5448
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Fax |
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Provider Business Mailing Address
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Address Line | 12618 DAVIS RD
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City | WOODSTOCK
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State | IL
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Zip | 60098-9253
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Country | US
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Telephone | 815-861-5448
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | SERENA FRANCKOWIAK
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Credential |
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Telephone | 815-861-5448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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