| Forest City Behavior Llc | |
|
807 Monroe St Mendota IL 61342-1662 | |
| (815) 627-0641 | |
| (270) 514-8294 |
| Full Name | Forest City Behavior Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 807 Monroe St, Mendota, Illinois |
| Authorized Official Name and Position | Erin Wade (PRESIDENT) |
| Authorized Official Contact | 8156270641 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Forest City Behavior Llc 807 Monroe St Mendota IL 61342-1662 Ph: (815) 627-0641 | Forest City Behavior Llc 807 Monroe St Mendota IL 61342-1662 Ph: (815) 627-0641 |
| NPI Number | 1073966719 |
|---|---|
| Provider Enumeration Date | 07/18/2016 |
| Last Update Date | 07/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073966719 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | 071-007297 (Illinois) | Secondary |
Changes Counseling, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1315 Memorial Dr, Mendota, IL 61342 Phone: 815-501-2088 |