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750 Broadway Ave E Mattoon IL 61938-4610 | |
| (217) 238-5700 | |
| (217) 238-5767 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 750 Broadway Ave E, Mattoon, Illinois |
| Authorized Official Name and Position | Angie Williams (ACCESS CENTER COORDINATOR) |
| Authorized Official Contact | 2172385700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
750 Broadway Ave E Mattoon IL 61938-4610 Ph: (217) 238-5700 | 750 Broadway Ave E Mattoon IL 61938-4610 Ph: (217) 238-5700 |
| NPI Number | 1700053253 |
|---|---|
| Provider Enumeration Date | 05/14/2008 |
| Last Update Date | 06/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700053253 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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