| Organization Name: | SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP |
| NPI Number: | 1639295314 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PATSY JENSEN (CEO) |
| Mailing Address: | 109 California St Carterville |
| State: | IL US |
| Postal Code: | 629180577 |
| Phone Number: | 6189858221 |
| Fax Number: | 6189856860 |
| NPI Enumeration Date: | 03/22/2007 |
| NPI Last Update Date: | 05/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |