| Braintique Llc | |
|
8 S Main St Ste 201 Canton IL 61520-2680 | |
| (309) 648-9216 | |
| Not Available |
| Full Name | Braintique Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 8 S Main St Ste 201, Canton, Illinois |
| Authorized Official Name and Position | Layne Denise Stambaugh (OWNER) |
| Authorized Official Contact | 3096489216 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Braintique Llc 8 S Main St Ste 201 Canton IL 61520-2680 Ph: (309) 648-9216 | Braintique Llc 8 S Main St Ste 201 Canton IL 61520-2680 Ph: (309) 648-9216 |
| NPI Number | 1497587257 |
|---|---|
| Provider Enumeration Date | 08/19/2024 |
| Last Update Date | 08/19/2024 |
| Certification Date | 08/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497587257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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