| Arrowhead Ranch | |
|
12200 104th St Coal Valley IL 61240-9712 | |
| (309) 799-7044 | |
| Not Available |
| Full Name | Arrowhead Ranch |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 12200 104th St, Coal Valley, Illinois |
| Authorized Official Name and Position | Chelease Machay Parks (DIRECTOR OF STATE PROGRAMS) |
| Authorized Official Contact | 3097997044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Arrowhead Ranch 12200 104th St P.o. Box 370 Coal Valley IL 61240-9712 Ph: (309) 799-7044 | Arrowhead Ranch 12200 104th St Coal Valley IL 61240-9712 Ph: (309) 799-7044 |
| NPI Number | 1407026511 |
|---|---|
| Provider Enumeration Date | 03/04/2008 |
| Last Update Date | 09/17/2020 |
| Certification Date | 09/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407026511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
The Robert Young Center For Community Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 12200 104th St, Coal Valley, IL 61240 Phone: 309-799-7044 |