SHELBY COUNTY COMMUNITY SERVICES INC NPI 1154571701

NPI Information

NPI: 1154571701
Provider Name: SHELBY COUNTY COMMUNITY SERVICES INC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
101 E NORTH 12TH ST
SHELBYVILLE, IL
ZIP 62565
Phone: (217) 774-1400
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SHELBY COUNTY COMMUNITY SERVICES INC is a rehabilitation and substance use disorder clinic center in Shelbyville, IL. SHELBY COUNTY COMMUNITY SERVICES INC NPI is 1154571701. The provider is registered as an organization entity type.

The provider's business location address is:

101 E NORTH 12TH ST
SHELBYVILLE, IL
ZIP 62565-388
Phone: (217) 774-1400
Fax: (217) 774-1426

The provider's authorized official is Thomas Colclasure .
The authorized official title is Executive Director and has the following contact phone number (217) 774-5587.

The enumeration date for this NPI number is 9/19/2008 and was last updated on 10/17/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========003	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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