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General NPI Number Information
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NPI Number | 1689117640
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Entity Type | Organization
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Legal Business Name | ABC COUNSELING AND FAMILY SERVICES
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Dates
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Enumeration Date | 11/23/2016
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Last Update Date | 11/23/2016
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Provider Practice Location Address
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Address Line | 1110 ARBOR DR STE C
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City | DECATUR
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State | IL
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Zip | 62526-9285
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Country | US
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Telephone | 217-877-9217
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Fax | 217-877-9218
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Provider Business Mailing Address
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Address Line | 1110 ARBOR DR STE C
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City | DECATUR
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State | IL
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Zip | 62526-9285
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Country | US
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Telephone | 217-877-9217
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Fax | 217-877-9218
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Authorized Official
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Title or Position | BILLING COORDINATOR
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Name | MELISSA BOX
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Credential |
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Telephone | 639-451-9495
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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 |
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License Number State |
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