Basic Information
| Provider Information | |||||||||
| NPI: | 1023678521 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HUMAN RESOURCES CENTER OF EDGAR AND CLARK COUNTIES | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1118 | ||||||||
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| City: | PARIS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 619445118 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 406 NORTH 2ND STREET | ||||||||
| Address2: | |||||||||
| City: | MARSHALL | ||||||||
| State: | IL | ||||||||
| PostalCode: | 62441 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2178266212 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2019 | ||||||||
| LastUpdateDate: | 06/17/2019 | ||||||||
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| AuthorizedOfficialLastName: | DEAL | ||||||||
| AuthorizedOfficialFirstName: | LORITA | ||||||||
| AuthorizedOfficialMiddleName: | KAY | ||||||||
| AuthorizedOfficialTitleorPosition: | FINANCE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2174654118 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health | 1041C0700X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.