Healthcare Provider Details

I. General information

NPI: 1174350177
Provider Name (Legal Business Name): CASS COUNTY MENTAL HEALTH ASSOC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 BRIDGEVIEW BLDG C
BEARDSTOWN IL
62618-1069
US

IV. Provider business mailing address

7 BRIDGEVIEW BLDG C
BEARDSTOWN IL
62618-1069
US

V. Phone/Fax

Practice location:
  • Phone: 217-323-1239
  • Fax: 217-323-4036
Mailing address:
  • Phone: 217-323-1239
  • Fax: 217-323-4036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: AMANDA J BECHARD
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 217-323-2980