Provider Demographics
NPI:1497955736
Name:SINNISSIPPI CENTERS INC.
Entity Type:Organization
Organization Name:SINNISSIPPI CENTERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APARTMENT SUPPORT STAFF
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:VENGHAUS
Authorized Official - Suffix:
Authorized Official - Credentials:MHP
Authorized Official - Phone:815-622-0938
Mailing Address - Street 1:2104 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-1608
Mailing Address - Country:US
Mailing Address - Phone:815-622-0938
Mailing Address - Fax:
Practice Address - Street 1:2104 E 23RD ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:IL
Practice Address - Zip Code:61081-1608
Practice Address - Country:US
Practice Address - Phone:815-622-0938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health