| Organization Name: | FAYETTE COUNTY |
| NPI Number: | 1174523914 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RHONDA ANDREWS (ADMINISTRATOR) |
| Mailing Address: | 120 N 5th St Vandalia |
| State: | IL US |
| Postal Code: | 624712206 |
| Phone Number: | 6182837262 |
| Fax Number: | 6182835039 |
| NPI Enumeration Date: | 07/22/2005 |
| NPI Last Update Date: | 12/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 1863108 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |