| Martin Luther King Jr. Community Service Area Project | |
|
555 N Court St Ste 204 Rockford IL 61103-6898 | |
| (815) 233-9915 | |
| (815) 962-2180 |
| Full Name | Martin Luther King Jr. Community Service Area Project |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 555 N Court St Ste 204, Rockford, Illinois |
| Authorized Official Name and Position | Charles W Collins (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8152339915 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Martin Luther King Jr. Community Service Area Project 555 N Court St Ste 204 Rockford IL 61103-6898 Ph: (815) 233-9915 | Martin Luther King Jr. Community Service Area Project 555 N Court St Ste 204 Rockford IL 61103-6898 Ph: (815) 233-9915 |
| NPI Number | 1619118304 |
|---|---|
| Provider Enumeration Date | 03/10/2009 |
| Last Update Date | 03/10/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619118304 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 08002 (Illinois) | Primary |
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