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General NPI Number Information
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NPI Number | 1669818837
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Entity Type | Organization
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Legal Business Name | FEATHERS BEHAVIORAL HEALTH SERVICES, INC
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Dates
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Enumeration Date | 05/15/2013
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Last Update Date | 05/15/2013
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Provider Practice Location Address
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Address Line | 4320 SPRING CREEK RD
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City | ROCKFORD
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State | IL
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Zip | 61107-1175
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Country | US
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Telephone | 779-200-2857
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Fax | 888-300-6201
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Provider Business Mailing Address
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Address Line | 4320 SPRING CREEK RD
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City | ROCKFORD
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State | IL
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Zip | 61107-1175
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Country | US
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Telephone | 779-200-2857
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Fax | 888-300-6201
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | CHRISTINE BLAKE FEATHERS
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Credential | LCSW
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Telephone | 815-494-4012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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