Healthcare Provider Details

I. General information

NPI: 1942578141
Provider Name (Legal Business Name): CASS COUNTY MENTAL HEALTH ASSOC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2011
Last Update Date: 03/10/2020
Certification Date: 03/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 E 2ND ST
BEARDSTOWN IL
62618-1263
US

IV. Provider business mailing address

121 E 2ND ST
BEARDSTOWN IL
62618-1263
US

V. Phone/Fax

Practice location:
  • Phone: 217-323-2980
  • Fax: 217-323-3731
Mailing address:
  • Phone: 217-323-2980
  • Fax: 217-323-3731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS CHERYL BAUSER
Title or Position: SASS FAMILY RESOURCE DEVELOPER
Credential: RSA
Phone: 217-323-2980