NPI 1457654295 BEN GORDON CENTER MALTA IL. Find Phone Number, Address, Contact details of medical healthcare providers | NPI Number Lookup

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Ben Gordon Center - NPI: 1457654295

National Provider Identifier (NPI) is a 10-digit identification number which is issued to health care providers by the Centers for Medicare and Medicaid Services (CMS) in the United States(US). The NPI is introduced to replace of UPIN (unique provider identification number) and now NPI is the only required identifier for Medicare services, and NPI is also used by commercial healthcare insurers and by other payers.

Organization Name: BEN GORDON CENTER
NPI Number: 1457654295
Entity Type Code: Organizational (2)
Authorized Official Name: MICHAEL FLORA
(CEO/PRESIDENT)
Mailing Address: 21193 Malta Rd Bldg. A - U154
Malta
State: IL US
Postal Code: 601509600
Phone Number: 8157564875
Fax Number: 8157562944
NPI Enumeration Date: 12/17/2010
NPI Last Update Date: 12/17/2010
Replacement NPI: 0
NPI Deactivation Date:
NPI Reactivation Date:

Taxonomy Information:

Healthcare Provider Taxonomy: 261QM0801X
License Number: A0254001A
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:


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