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801 S West St Ste 121 Olney IL 62450-1334 | |
| (217) 238-5700 | |
| (217) 238-5767 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 801 S West St Ste 121, Olney, Illinois |
| Authorized Official Name and Position | Joseph King (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2172385700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
801 S West St Ste 121 Olney IL 62450-1334 Ph: (217) 238-5700 | 801 S West St Ste 121 Olney IL 62450-1334 Ph: (217) 238-5700 |
| NPI Number | 1609385269 |
|---|---|
| Provider Enumeration Date | 09/27/2017 |
| Last Update Date | 11/18/2024 |
| Certification Date | 11/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609385269 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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