| Organization Name: | PERRY COUNTY COUNSELING CENTER INC |
| NPI Number: | 1417010760 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN R VENSKUS (ADMINISTRATOR) |
| Mailing Address: | 1016 S Madison St Suite A Du Quoin |
| State: | IL US |
| Postal Code: | 628322442 |
| Phone Number: | 6185424357 |
| Fax Number: | 6185423442 |
| NPI Enumeration Date: | 12/18/2006 |
| NPI Last Update Date: | 06/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |