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NPI 1629629357

OrganizationActive

Shawnee Health Service and Development Corp

NPI 1629629357 · Methadone Clinic · Carbondale, IL

Provider details

NPI number: 1629629357
Entity type: Organization
Primary specialty: Methadone ClinicAmbulatory Health Care Facilities
Parent organization: Shawnee Health Service and Development Corp
Authorized official: Patsy Jensen, Ceo

Practice location

400 S Lewis Ln

Carbondale, IL 62901-3547

Phone: (618) 519-9200

Fax: (618) 519-9961

More IL providers

Mailing address

Po Box 577

Carterville, IL 62918-0577

Registry dates

Enumerated: 2019-09-24
Last updated: 2019-09-24

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Shawnee Health Service and Development Corp — NPI 1629629357, Carbondale, IL | NPI Central