| Organization Name: | SOUTHEASTERN IL COUNSELING CTRS INC. |
| NPI Number: | 1114376092 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TRACY J HORD (A/R CLERK) |
| Mailing Address: | 204 W Highland Ave Robinson |
| State: | IL US |
| Postal Code: | 624541710 |
| Phone Number: | 6185465232 |
| Fax Number: | 6185465657 |
| NPI Enumeration Date: | 06/10/2016 |
| NPI Last Update Date: | 06/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |