| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 904 Vine Street, Vienna, Illinois |
| Authorized Official Name and Position | Laura K Cowser (FINANCIAL DIRECTOR) |
| Authorized Official Contact | 6186522046 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
125 North Market Street Po Box 759 Golconda IL 62938 Ph: (618) 683-2461 | 904 Vine Street Vienna IL 62995 Ph: (618) 658-4047 |
| NPI Number | 1780831453 |
|---|---|
| Provider Enumeration Date | 08/25/2008 |
| Last Update Date | 11/18/2021 |
| Certification Date | 11/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780831453 | NPI | - | NPPES |
Arrowleaf Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 Red Bud Ln, Vienna, IL 62995 Phone: 618-658-3079 | |
Family Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 408 E Vine St, Same, Vienna, IL 62995 Phone: 618-658-2611 | |
Lutheran Social Services Of Illinois Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 45 Industrial Dr, Vienna, IL 62995 Phone: 618-658-9512 Fax: 618-658-8151 |