| Skill Sprout, Llc | |
|
8500 N Knoxville Ave Ste Ab Peoria IL 61615-2079 | |
| (800) 773-1682 | |
| (309) 713-2898 |
| Full Name | Skill Sprout, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 8500 N Knoxville Ave, Peoria, Illinois |
| Authorized Official Name and Position | Rose Cree (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 8007731682 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Skill Sprout, Llc 97 Eastgate Dr Washington IL 61571-9271 Ph: (800) 773-1682 | Skill Sprout, Llc 8500 N Knoxville Ave Ste Ab Peoria IL 61615-2079 Ph: (800) 773-1682 |
| NPI Number | 1396106647 |
|---|---|
| Provider Enumeration Date | 03/15/2016 |
| Last Update Date | 03/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396106647 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149.016759 (Illinois) | Primary |
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