MEDICARE: CALL FOR HELP, INC.

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	04018	IL

General Provider Information

NPI Number	:	1942741269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALL FOR HELP, INC.

Provider Business Mailing Address
First Line	:	9400 LEBANON RD
Second Line	:
City	:	EAST SAINT LOUIS
State	:	IL
Zip	:	62203-2214
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9400 LEBANON RD
Second Line	:
City	:	EAST SAINT LOUIS
State	:	IL
Zip	:	62203-2214
Country	:	US
Telephone Number	:	618-397-0968
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	JAMES KELLERMANN
Credential	:
Telephone Number	:	619-397-0968

Provider Enumeration Date	:	03/20/2017
Last Update Date	:	04/19/2017

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