| Locust Street Resource Center - Jacksonville | |
|
60 E Central Park Plz Jacksonville IL 62650-2071 | |
| (217) 854-3166 | |
| (217) 854-3778 |
| Full Name | Locust Street Resource Center - Jacksonville |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 60 E Central Park Plz, Jacksonville, Illinois |
| Authorized Official Name and Position | Elizabeth Scherer (BILLING/CREDENTIALING) |
| Authorized Official Contact | 2178543166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Locust Street Resource Center - Jacksonville 320 S Locust St Carlinville IL 62626-1648 Ph: (217) 854-3166 | Locust Street Resource Center - Jacksonville 60 E Central Park Plz Jacksonville IL 62650-2071 Ph: (217) 854-3166 |
| NPI Number | 1225729783 |
|---|---|
| Provider Enumeration Date | 05/16/2023 |
| Last Update Date | 10/24/2024 |
| Certification Date | 10/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225729783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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