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421 W Exchange St Freeport IL 61032-4030 | |
| (815) 599-7300 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 421 W Exchange St, Freeport, Illinois |
| Authorized Official Name and Position | Kathryn Martinez (VPOF PATIENT SERVICES) |
| Authorized Official Contact | 8155997529 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 813 421 W Exchange St. Freeport IL 61032-0813 Ph: () - | 421 W Exchange St Freeport IL 61032-4030 Ph: (815) 599-7300 |
| NPI Number | 1124190335 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 11/05/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124190335 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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