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General NPI Number Information
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NPI Number | 1871677039
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Entity Type | Organization
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Legal Business Name | SINNISSIPPI CENTERS INC.
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 325 IL ROUTE 2
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City | DIXON
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State | IL
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Zip | 61021-9118
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Country | US
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Telephone | 815-284-6611
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Fax |
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Provider Business Mailing Address
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Address Line | 7865 S CLINTON ST
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City | DIXON
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State | IL
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Zip | 61021-9410
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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 OF ADDICTIONS
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Name | MS. NATALIE A ANDREWS
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Credential | LCSW, CADC
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Telephone | 815-284-6611
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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 | IL
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