Provider First Line Business Practice Location Address:
101 SOUTH LINCOLN STREET
Provider Second Line Business Practice Location Address:
CHILD & FAMILY CONNECTIONS
Provider Business Practice Location Address City Name:
CENTRALIA
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62801-0900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-532-4919
Provider Business Practice Location Address Fax Number:
618-532-0856
Provider Enumeration Date:
07/20/2006