| Jacque Ruch Lcsw, Ltd. | |
|
6975 Redansa Dr Rockford IL 61108-1201 | |
| (815) 398-7000 | |
| (815) 395-0671 |
| Full Name | Jacque Ruch Lcsw, Ltd. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6975 Redansa Dr, Rockford, Illinois |
| Authorized Official Name and Position | Jacquelyn J Ruch (OWNER) |
| Authorized Official Contact | 8152438332 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacque Ruch Lcsw, Ltd. 4635 Bedfordshire Dr Loves Park IL 61111-4481 Ph: (815) 243-8332 | Jacque Ruch Lcsw, Ltd. 6975 Redansa Dr Rockford IL 61108-1201 Ph: (815) 398-7000 |
| NPI Number | 1760885255 |
|---|---|
| Provider Enumeration Date | 09/29/2014 |
| Last Update Date | 09/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760885255 | NPI | - | NPPES |
| 1407129471 | Other | IL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 149015073 (Illinois) | Primary |
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