| Javon Bea Hospital | |
|
2400 N Rockton Ave Rockford IL 61103 | |
| (815) 971-5000 | |
| (815) 968-0170 |
| Full Name | Javon Bea Hospital |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 2400 N Rockton Ave, Rockford, Illinois |
| Authorized Official Name and Position | Todd Anderson (VP/CFO) |
| Authorized Official Contact | 6087566000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Javon Bea Hospital 2400 N Rockton Ave Rockford IL 61103-3655 Ph: (815) 971-5000 | Javon Bea Hospital 2400 N Rockton Ave Rockford IL 61103 Ph: (815) 971-5000 |
| NPI Number | 1437367166 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 07/23/2020 |
| Certification Date | 07/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437367166 | NPI | - | NPPES |
| 720850200 | Medicaid | MN | |
| XHSP30083 | Medicaid | CA | |
| 11002400 | Medicaid | WI | |
| 0927533 | Medicaid | IA | |
| 14S239 | Other | IL | IL MEDICARE |
| 011307204 | Medicaid | MO | |
| 1400239 | Medicaid | NC | |
| 090109100 | Medicaid | FL | |
| 100034510A | Medicaid | IN | |
| 1121340 | Medicaid | PA | |
| 108771105 | Medicaid | AR | |
| 372 | Other | BLUE CROSS BLUE SHEILD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 0002048 (Illinois) | Primary |
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