Organization Name: | NORTH CENTRAL BEHAVIORAL HEALTH SYSTEMS, INC. |
NPI Number: | 1134249550 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LARRY BLOCK (VP-FINANCE) |
Mailing Address: | 727 Etna Rd. Ottawa |
State: | IL US |
Postal Code: | 61350 |
Phone Number: | 8152230160 |
Fax Number: | 8152231634 |
NPI Enumeration Date: | 03/30/2007 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |