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NPI Code Detail

MEDICARE: CATHOLIC SOCIAL SERVICES CARBONDALE

MEDICARE: CATHOLIC SOCIAL SERVICES CARBONDALE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253J00000XFoster Care Agency003967-11IL

General Provider Information

NPI Number : 1104156439
Entity Type Code : Organization
Provider Name (Legal Business Name) : CATHOLIC SOCIAL SERVICES CARBONDALE
Provider Business Mailing Address
First Line : 214 S UNIVERSITY AVE
Second Line :
City : CARBONDALE
State : IL
Zip : 62901-2925
Country : US
Telephone Number : 618-351-0743
Fax Number : 618-351-0945
Provider Business Practice Location Address
First Line : 214 S UNIVERSITY AVE
Second Line :
City : CARBONDALE
State : IL
Zip : 62901-2925
Country : US
Telephone Number : 618-351-0743
Fax Number : 618-351-0945
Authorized Official
Title or Position : FINANCE DIRECTOR
Name : MR. GARY B SCHMITT
Credential : MBA
Telephone Number : 618-688-1127
Provider Enumeration Date : 01/08/2010
Last Update Date : 01/08/2010

Similar Medicare Providers

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Practice Location Address:
212 S UNIVERSITY AVE
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Practice Fax:
1942370051 — MS. JUDY A. ASHBY MS LCPC
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1659428845 — MRS. CHRISTINA OKPO UMANA MS NCC LPC AMFT
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214 S UNIVERSITY AVE
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Practice Fax: 618-351-0945
1467519652 — MRS. KAREN ANN HENDERSON MSW, LCSW
Practice Location Address:
214 S UNIVERSITY AVE
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Practice Fax:
1073842423 — MS. JENNIFER ARI ROSE AMFT LPC
Practice Location Address:
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1598031700 — CHRISTIAN SOCIAL SERVICES OF ILLINOIS
Practice Location Address:
214 S UNIVERSITY AVE
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62901-2925
Practice Phone: 618-351-0743
Practice Fax: 618-351-0945

Directions to “CATHOLIC SOCIAL SERVICES CARBONDALE ” Practice Location

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