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General NPI Number Information
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NPI Number | 1518398510
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Entity Type | Organization
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Legal Business Name | THE ATTACHMENT GROUP
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Dates
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Enumeration Date | 12/02/2013
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Last Update Date | 11/01/2016
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Provider Practice Location Address
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Address Line | 4873 MANHATTAN DR
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City | ROCKFORD
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State | IL
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Zip | 61108-2265
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Country | US
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Telephone | 815-398-8422
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6472
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City | ROCKFORD
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State | IL
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Zip | 61125-1472
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. CHRISTINE APPELL
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Credential | LCPC
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Telephone | 815-398-8422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 180000689
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License Number State | IL
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