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General NPI Number Information
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NPI Number | 1144031857
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Entity Type | Organization
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Legal Business Name | FIRST CALL BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 2232 DELL RANGE BLVD STE 242
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City | CHEYENNE
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State | WY
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Zip | 82009-4979
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Country | US
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Telephone | 800-647-1244
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Fax |
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Provider Business Mailing Address
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Address Line | 211 BUNKER DR
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City | SCHERERVILLE
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State | IN
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Zip | 46375-2035
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Country | US
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Telephone | 773-354-8990
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JEROME WILSON
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Credential | PA
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Telephone | 773-354-8990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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