Provider Demographics
NPI:1205143351
Name:TRI-COUNTY OPPORTUNITIES COUNCIL
Entity type:Organization
Organization Name:TRI-COUNTY OPPORTUNITIES COUNCIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:JULIFS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-625-7830
Mailing Address - Street 1:405 EMMONS AVE
Mailing Address - Street 2:P.O. BOX 610
Mailing Address - City:ROCK FALLS
Mailing Address - State:IL
Mailing Address - Zip Code:61071-1407
Mailing Address - Country:US
Mailing Address - Phone:815-625-7830
Mailing Address - Fax:
Practice Address - Street 1:405 EMMONS AVE
Practice Address - Street 2:
Practice Address - City:ROCK FALLS
Practice Address - State:IL
Practice Address - Zip Code:61071-1407
Practice Address - Country:US
Practice Address - Phone:815-625-7830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL172A00000XMedicaid
IL=========OtherTRANSPORTATION PROVIDER