Healthcare Provider Details
I. General information
NPI: 1669564662
Provider Name (Legal Business Name): SARAH BUSH LINCOLN HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/28/2006
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 HEALTH CENTER DR
MATTOON IL
61938-9253
US
IV. Provider business mailing address
PO BOX 372
MATTOON IL
61938-0372
US
V. Phone/Fax
- Phone: 217-258-2525
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 273R00000X |
| Taxonomy | Psychiatric Hospital Unit |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | 0003392 |
| License Number State | IL |
VIII. Authorized Official
Name:
SEAN
FISCHER
Title or Position: CHIEF FINANCIAL OFFICER
Credential: CFO
Phone: 217-258-2591