Organization Name: | CENTER FOR RURAL PSYCHOLOGY |
NPI Number: | 1356451009 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL WILLIAM MANGIS (EXECUTIVE DIRECTOR) |
Mailing Address: | 106 W Pierce St Elburn |
State: | IL US |
Postal Code: | 601198201 |
Phone Number: | 6303650899 |
Fax Number: | 6303659150 |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 02/13/2008 |
Replacement NPI: | 0 |
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Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251V00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Voluntary or Charitable |
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