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General NPI Number Information
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NPI Number | 1932470606
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Entity Type | Organization
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Legal Business Name | IROQUOIS MENTAL HEALTH CENTER
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Dates
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Enumeration Date | 01/26/2012
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Last Update Date | 01/26/2012
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Provider Practice Location Address
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Address Line | 200 S. LOCUST ST.
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City | LODA
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State | IL
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Zip | 60948
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Country | US
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Telephone | 815-432-5241
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Fax | 815-432-4537
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Provider Business Mailing Address
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Address Line | 200 S. LOCUST ST.
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City | LODA
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State | IL
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Zip | 60948
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Country | US
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Telephone | 815-432-5241
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Fax | 815-432-4537
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Authorized Official
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Title or Position | EXECUITVE DIRECTOR
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Name | DR. DENNIS P HOPKINS
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Credential | PSYD;MBA
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Telephone | 815-432-5241
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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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