| Janet Wattles Center | |
|
2406 Auburn St Rockford IL 61103-4495 | |
| (815) 968-9300 | |
| Not Available |
| Full Name | Janet Wattles Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2406 Auburn St, Rockford, Illinois |
| Authorized Official Name and Position | Phil Eaton (CEO/PRESIDENT) |
| Authorized Official Contact | 8159689300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Janet Wattles Center 526 W State St Rockford IL 61101-1214 Ph: (815) 968-9300 | Janet Wattles Center 2406 Auburn St Rockford IL 61103-4495 Ph: (815) 968-9300 |
| NPI Number | 1659668333 |
|---|---|
| Provider Enumeration Date | 07/01/2011 |
| Last Update Date | 07/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659668333 | NPI | - | NPPES |
| 022 | Medicaid | IL | |
| 10120962 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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