Mended Hearts Stable | |
1431 Lourdes Rd Metamora IL 61548-7609 | |
(309) 383-4323 | |
(309) 383-3399 |
Full Name | Mended Hearts Stable |
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Speciality | Clinic/center - Adolescent And Children Mental Health |
Location | 1431 Lourdes Rd, Metamora, Illinois |
Authorized Official Name and Position | Julie Elise Sellner (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 3093834323 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Mended Hearts Stable 1431 Lourdes Rd Metamora IL 61548-7609 Ph: (309) 383-4323 | Mended Hearts Stable 1431 Lourdes Rd Metamora IL 61548-7609 Ph: (309) 383-4323 |
NPI Number | 1922283464 |
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Provider Enumeration Date | 01/03/2008 |
Last Update Date | 07/10/2024 |
Certification Date | 07/10/2024 |
Identifier | Type | State | Issuer |
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1922283464 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | 180005723 (Illinois) | Secondary |
261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
New Heights Counseling Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 610 State Route 116, Metamora, IL 61548 Phone: 309-840-3885 |