Sihf Psr Club House Facility

LBN: Southern Illinois Healthcare Foundation, Inc.
Sihf Psr Club House Facility is an health care organization with primary practice located at 2057 Edison Ave Suite A, Granite City IL 62040-4514. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Psychiatry, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty. Southern Illinois Healthcare Foundation, Inc. can be contacted via phone (618) 397-3303, or through Mcculley, Larry via phone (618) 332-0694.

Contact Information

Primary practice address
2057 Edison Ave Suite A Granite City IL 62040-4514
Phone: (618) 397-3303
Fax: (618) 397-7802
Website:
Map and Directions
Authorized official contact:
Name: Mcculley, Larry
Phone: (618) 332-0694

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X

Profile Details

NPI number 1821277658
LBN Legal business name Southern Illinois Healthcare Foundation, Inc.
DBA Doing business as Sihf Psr Club House Facility
Authorized official Mcculley, Larry
Entity Organization
Organization subpart 1 No
Enumeration date Oct 29th, 2007
Last updated Oct 29th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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