| Lssi Nachusa | |
|
1261 Il Rte 38 Nachusa IL 61057 | |
| (815) 284-7796 | |
| (815) 284-6162 |
| Full Name | Lssi Nachusa |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1261 Il Rte 38, Nachusa, Illinois |
| Authorized Official Name and Position | Mark Stutrud (PRESIDENT) |
| Authorized Official Contact | 8476354600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lssi Nachusa Po Box 100 Nachusa IL 61057-0100 Ph: (815) 284-7796 | Lssi Nachusa 1261 Il Rte 38 Nachusa IL 61057 Ph: (815) 284-7796 |
| NPI Number | 1326216151 |
|---|---|
| Provider Enumeration Date | 02/14/2008 |
| Last Update Date | 08/03/2022 |
| Certification Date | 08/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326216151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |