| Good Shepherd Foundation Of Henry County | |
|
796 Boone Dr Geneseo IL 61254-1783 | |
| (309) 944-6205 | |
| (309) 944-3258 |
| Full Name | Good Shepherd Foundation Of Henry County |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 796 Boone Dr, Geneseo, Illinois |
| Authorized Official Name and Position | Lynn Roesner (DIRECTOR) |
| Authorized Official Contact | 3099446205 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Shepherd Foundation Of Henry County 796 Boone Dr Geneseo IL 61254-1783 Ph: (309) 944-6205 | Good Shepherd Foundation Of Henry County 796 Boone Dr Geneseo IL 61254-1783 Ph: (309) 944-6205 |
| NPI Number | 1649519620 |
|---|---|
| Provider Enumeration Date | 02/11/2013 |
| Last Update Date | 02/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649519620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | A-9103-0002-A (Illinois) | Primary |
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