| Fundamental Behavioral Health | |
|
604 Beverly Ln Collinsville IL 62234-2912 | |
| (618) 401-8225 | |
| Not Available |
| Full Name | Fundamental Behavioral Health |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 604 Beverly Ln, Collinsville, Illinois |
| Authorized Official Name and Position | Joellen Juenger (FNP-BC, PMHNP-BC) |
| Authorized Official Contact | 6184018225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fundamental Behavioral Health Po Box 204 Collinsville IL 62234-0204 Ph: (618) 401-8225 | Fundamental Behavioral Health 604 Beverly Ln Collinsville IL 62234-2912 Ph: (618) 401-8225 |
| NPI Number | 1194404319 |
|---|---|
| Provider Enumeration Date | 07/14/2023 |
| Last Update Date | 01/09/2024 |
| Certification Date | 01/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194404319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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