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General NPI Number Information
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NPI Number | 1457358285
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Entity Type | Organization
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Legal Business Name | FORD-IROQUOIS PUBLIC HEALTH DEPT
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 01/10/2013
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Provider Practice Location Address
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Address Line | 114 N 3RD ST
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City | WATSEKA
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State | IL
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Zip | 60970-1302
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Country | US
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Telephone | 815-432-2483
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Fax | 815-432-2198
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Provider Business Mailing Address
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Address Line | 114 N 3RD ST
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City | WATSEKA
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State | IL
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Zip | 60970-1302
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Country | US
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Telephone | 815-432-2483
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Fax | 815-432-2198
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Authorized Official
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Title or Position | FINANCIAL AID COORDINATOR
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Name | MRS. CARY ELIZABETH HAGEN
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Credential |
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Telephone | 815-432-2483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 1001528
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 1001528
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 1001528
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1001528
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License Number State | IL
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