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NPI Code Detail

MEDICARE: ALEXIAN BROTHERS CENTER FOR MENTAL HEALTH

MEDICARE: ALEXIAN BROTHERS CENTER FOR MENTAL HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11617886OTHERILBLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689674038
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALEXIAN BROTHERS CENTER FOR MENTAL HEALTH
Provider Business Mailing Address
First Line : PO BOX 26852
Second Line :
City : BELFAST
State : ME
Zip : 04915-2019
Country : US
Telephone Number : 847-952-7460
Fax Number : 847-222-1754
Provider Business Practice Location Address
First Line : 3436 N. KENNICOTT AVENUE
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-7814
Country : US
Telephone Number : 847-952-7460
Fax Number : 847-222-1754
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : RICK GERMANN
Credential :
Telephone Number : 847-952-7460
Provider Enumeration Date : 07/28/2005
Last Update Date : 01/23/2025

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1609013077 — ALEXIAN BROTHERS CENTER FOR MENTAL HEALTH
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Practice Phone: 847-952-7460
Practice Fax: 847-222-1754

Directions to “ALEXIAN BROTHERS CENTER FOR MENTAL HEALTH ” Practice Location

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