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General NPI Number Information
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NPI Number | 1184071136
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Entity Type | Organization
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Legal Business Name | RICHLAND FAMILY COUNSELING CTRS INC
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Dates
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Enumeration Date | 05/19/2016
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Last Update Date | 05/19/2016
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Provider Practice Location Address
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Address Line | 504 MICAH DR DRAWER M
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City | OLNEY
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State | IL
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Zip | 62450-4720
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Country | US
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Telephone | 618-395-4309
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Fax | 618-395-4507
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Provider Business Mailing Address
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Address Line | 504 MICAH DR DRAWER M
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City | OLNEY
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State | IL
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Zip | 62450-4720
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Country | US
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Telephone | 618-395-4309
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Fax | 618-395-4507
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Authorized Official
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Title or Position | A/R CLERK
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Name | MRS. TRACY J HORD
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Credential | AAS
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Telephone | 618-395-4309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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