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6000 Bond Ave Centreville IL 62207-2328 | |
| (618) 332-2740 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 6000 Bond Ave, Centreville, Illinois |
| Authorized Official Name and Position | Larry Mcculley (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6183320694 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2041 Goose Lake Rd Sauget IL 62206-2822 Ph: (618) 332-0953 | 6000 Bond Ave Centreville IL 62207-2328 Ph: (618) 332-2740 |
| NPI Number | 1902963028 |
|---|---|
| Provider Enumeration Date | 01/02/2007 |
| Last Update Date | 08/30/2021 |
| Certification Date | 08/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902963028 | NPI | - | NPPES |
Children's Center For Behavioral Developement Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 353 N 88th St, Highway 157 South, Centreville, IL 62203 Phone: 618-398-1152 Fax: 618-398-6977 | |