Provider Demographics
NPI:1982122065
Name:PERSONS ASSUMING CONTROL OF THEIR ENVIRONMENT
Entity type:Organization
Organization Name:PERSONS ASSUMING CONTROL OF THEIR ENVIRONMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLELLAN-HICKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-344-5433
Mailing Address - Street 1:1317 E FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-6007
Mailing Address - Country:US
Mailing Address - Phone:217-344-5433
Mailing Address - Fax:217-344-2414
Practice Address - Street 1:1317 E FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801-6007
Practice Address - Country:US
Practice Address - Phone:217-344-5433
Practice Address - Fax:217-344-2414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency