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General NPI Number Information
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NPI Number | 1649574336
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Entity Type | Organization
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Legal Business Name | BLESSING HOSPITAL
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Dates
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Enumeration Date | 01/10/2011
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 1415 VERMONT ST
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City | QUINCY
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State | IL
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Zip | 62301-3119
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Country | US
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Telephone | 217-224-4453
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Fax | 217-224-9383
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Provider Business Mailing Address
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Address Line | 1005 BROADWAY ST
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City | QUINCY
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State | IL
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Zip | 62301-2834
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Country | US
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Telephone | 217-224-4453
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Fax | 217-224-9383
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Authorized Official
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Title or Position | CAO
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Name | MR. TIMOTHY A MOORE
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Credential |
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Telephone | 217-223-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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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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