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General NPI Number Information
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NPI Number | 1558910794
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS
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Dates
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Enumeration Date | 09/10/2019
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 303 E BIDWELL ST
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City | TAYLORVILLE
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State | IL
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Zip | 62568-1363
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Country | US
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Telephone | 217-525-1064
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Fax |
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Provider Business Mailing Address
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Address Line | 303 E BIDWELL ST
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City | TAYLORVILLE
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State | IL
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Zip | 62568-1363
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Country | US
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Telephone | 217-525-1064
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Fax | 217-525-1651
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Authorized Official
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Title or Position | DIRECTOR
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Name | ANN BOWLING
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Credential |
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Telephone | 217-588-2626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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