| Jubilee House Outreach | |
|
417 W College Ave Greenville IL 62246-1020 | |
| (618) 664-2360 | |
| Not Available |
| Full Name | Jubilee House Outreach |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 417 W College Ave, Greenville, Illinois |
| Authorized Official Name and Position | George R. Peters (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6186642360 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jubilee House Outreach 417 W College Ave Greenville IL 62246-1020 Ph: (618) 664-2360 | Jubilee House Outreach 417 W College Ave Greenville IL 62246-1020 Ph: (618) 664-2360 |
| NPI Number | 1215359880 |
|---|---|
| Provider Enumeration Date | 01/15/2014 |
| Last Update Date | 01/27/2014 |
| Medicare PECOS PAC ID | 6406076280 |
|---|---|
| Medicare Enrollment ID | O20140929001998 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215359880 | NPI | - | NPPES |
| Provider Name | Gregory E Pennington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073642294 PECOS PAC ID: 6002963386 Enrollment ID: I20090403000153 |
| Provider Name | Vaughn L Robart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851792782 PECOS PAC ID: 7416270905 Enrollment ID: I20150109000067 |
| Provider Name | Susan Kay Selock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649708926 PECOS PAC ID: 8426316290 Enrollment ID: I20171228000042 |
| Provider Name | Alison R Lanter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912313321 PECOS PAC ID: 3577928936 Enrollment ID: I20230508002557 |
| Provider Name | Susan Hughey-rasler |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1306056346 PECOS PAC ID: 8729977913 Enrollment ID: I20240227000441 |
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