| Southern Illinois Regional Social Services, Inc. | |
|
604 E College St Carbondale IL 62901-3309 | |
| (618) 457-6703 | |
| (618) 457-8377 |
| Full Name | Southern Illinois Regional Social Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 604 E College St, Carbondale, Illinois |
| Authorized Official Name and Position | Karen S Freitag (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6184576703 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Illinois Regional Social Services, Inc. 604 E College St Carbondale IL 62901-3309 Ph: (618) 457-6703 | Southern Illinois Regional Social Services, Inc. 604 E College St Carbondale IL 62901-3309 Ph: (618) 457-6703 |
| NPI Number | 1326238148 |
|---|---|
| Provider Enumeration Date | 07/27/2007 |
| Last Update Date | 01/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326238148 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 180006282 (Illinois) | Secondary |
| 251S00000X | Community/behavioral Health | A0243-0001-A (Illinois) | Primary |
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