| Springhealth Behavioral Health And Integrated Care Illinois, Llc | |
|
3921 Pintail Dr Ste B Springfield IL 62711-6738 | |
| (217) 843-0290 | |
| Not Available |
| Full Name | Springhealth Behavioral Health And Integrated Care Illinois, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3921 Pintail Dr Ste B, Springfield, Illinois |
| Authorized Official Name and Position | Angie Mattingly (MGR PROVIDER ENROLLMENT) |
| Authorized Official Contact | 5026307425 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Springhealth Behavioral Health And Integrated Care Illinois, Llc 805 N Whittington Pkwy Louisville KY 40222-7101 Ph: (502) 394-2100 | Springhealth Behavioral Health And Integrated Care Illinois, Llc 3921 Pintail Dr Ste B Springfield IL 62711-6738 Ph: (217) 843-0290 |
| NPI Number | 1063005288 |
|---|---|
| Provider Enumeration Date | 02/18/2021 |
| Last Update Date | 03/16/2022 |
| Certification Date | 03/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063005288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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