Provider First Line Business Practice Location Address:
120 SOUTH 11TH ST
Provider Second Line Business Practice Location Address:
CATHOLIC CHARITIES
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-525-0500
Provider Business Practice Location Address Fax Number:
217-525-0554
Provider Enumeration Date:
09/25/2006