1578600615 NPI number — DEWITT COUNTY HUMAN RESOURCE CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578600615 NPI number — DEWITT COUNTY HUMAN RESOURCE CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEWITT COUNTY HUMAN RESOURCE CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578600615
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 616
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLINTON
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
61727-0616
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
217-935-9496
Provider Business Mailing Address Fax Number:
217-935-4508

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1150 RT 54 WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLINTON
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-935-9496
Provider Business Practice Location Address Fax Number:
217-935-4508
Provider Enumeration Date:
01/30/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ADAMS-SNELSON
Authorized Official First Name:
SUE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
HUMAN RESOURCE ASSISTANT
Authorized Official Telephone Number:
217-935-9496

Provider Taxonomy Codes

  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)