Organization Name: | WHITESIDE COUNTY COMMUNITY HEALTH CLINIC |
NPI Number: | 1215237953 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BETH FIORINI (EXECUTIVE DIRECTOR) |
Mailing Address: | 1300 W 2nd St Rock Falls |
State: | IL US |
Postal Code: | 610711005 |
Phone Number: | 8156262230 |
Fax Number: | 8156262231 |
NPI Enumeration Date: | 10/28/2010 |
NPI Last Update Date: | 10/28/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | 149011944 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |