| Liberty Counseling Center, Inc | |
|
1429 S Main St Suite A Jacksonville IL 62650-3476 | |
| (217) 479-0691 | |
| (217) 478-2060 |
| Full Name | Liberty Counseling Center, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1429 S Main St, Jacksonville, Illinois |
| Authorized Official Name and Position | Sandra K Eyman (PRESIDENT/DIRECTOR) |
| Authorized Official Contact | 2174790691 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Counseling Center, Inc 1429 S Main St Suite A Jacksonville IL 62650-3476 Ph: (217) 479-0691 | Liberty Counseling Center, Inc 1429 S Main St Suite A Jacksonville IL 62650-3476 Ph: (217) 479-0691 |
| NPI Number | 1457658189 |
|---|---|
| Provider Enumeration Date | 02/15/2011 |
| Last Update Date | 02/15/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457658189 | NPI | - | NPPES |
| C/A-7302-0001-A | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | A-7302-0001-A (Illinois) | Primary |
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