Provider Demographics
NPI:1699003947
Name:CRAWFORD COUNTY SAFETY COUNCIL INC
Entity Type:Organization
Organization Name:CRAWFORD COUNTY SAFETY COUNCIL INC
Other - Org Name:WABASH VALLEY OCCUPATIONAL HEALTH (AND ACUTE CARE SERVICES)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:VEENSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-544-8333
Mailing Address - Street 1:1404 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROBINSON
Mailing Address - State:IL
Mailing Address - Zip Code:62454-3731
Mailing Address - Country:US
Mailing Address - Phone:618-544-8333
Mailing Address - Fax:618-544-3833
Practice Address - Street 1:1404 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ROBINSON
Practice Address - State:IL
Practice Address - Zip Code:62454-3731
Practice Address - Country:US
Practice Address - Phone:618-544-8333
Practice Address - Fax:618-544-3833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-25
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty