| Park Place Center | |
|
201 E Morgan St Jacksonville IL 62650-2508 | |
| (217) 245-1655 | |
| (217) 245-4742 |
| Full Name | Park Place Center |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 201 E Morgan St, Jacksonville, Illinois |
| Authorized Official Name and Position | Ed J Scott (DIRECTOR) |
| Authorized Official Contact | 2172451655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Place Center 201 E Morgan St P.o. Box 1304 Jacksonville IL 62650-2508 Ph: (217) 245-1655 | Park Place Center 201 E Morgan St Jacksonville IL 62650-2508 Ph: (217) 245-1655 |
| NPI Number | 1346451853 |
|---|---|
| Provider Enumeration Date | 05/25/2007 |
| Last Update Date | 10/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346451853 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149.003173 (Illinois) | Primary |
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