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1904 Eastgate St Olney IL 62450-3005 | |
| (618) 322-7455 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1904 Eastgate St, Olney, Illinois |
| Authorized Official Name and Position | David C Armbrust (MANAGER) |
| Authorized Official Contact | 6183227455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 745 Salem IL 62881-0745 Ph: (618) 548-0309 | 1904 Eastgate St Olney IL 62450-3005 Ph: (618) 322-7455 |
| NPI Number | 1699116251 |
|---|---|
| Provider Enumeration Date | 07/11/2013 |
| Last Update Date | 07/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699116251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 201200007M (Illinois) | Primary |
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