| Lincolnshire Group Home | |
|
1112 Lincolnshire Dr Champaign IL 61821-5606 | |
| (217) 398-8080 | |
| Not Available |
| Full Name | Lincolnshire Group Home |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1112 Lincolnshire Dr, Champaign, Illinois |
| Authorized Official Name and Position | Sheila Ferguson (CHIEF EXEC OFFICER) |
| Authorized Official Contact | 2173988080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lincolnshire Group Home 1801 Fox Dr Champaign IL 61820-7236 Ph: (217) 398-8080 | Lincolnshire Group Home 1112 Lincolnshire Dr Champaign IL 61821-5606 Ph: (217) 398-8080 |
| NPI Number | 1508013475 |
|---|---|
| Provider Enumeration Date | 08/22/2008 |
| Last Update Date | 09/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508013475 | NPI | - | NPPES |
| 1831167337 | Other | BLUE CROSS | |
| 1831167337 | Other | TRICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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