| The Josselyn Center Nfp | |
|
415 Washington St Ste 200 Waukegan IL 60085-5564 | |
| (847) 441-5600 | |
| (847) 441-7968 |
| Full Name | The Josselyn Center Nfp |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 415 Washington St Ste 200, Waukegan, Illinois |
| Authorized Official Name and Position | Kenneth G. Wiersum (VP OF FINANCE) |
| Authorized Official Contact | 8474415603 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Josselyn Center Nfp 405 Central Ave Northfield IL 60093-3006 Ph: (847) 441-5600 | The Josselyn Center Nfp 415 Washington St Ste 200 Waukegan IL 60085-5564 Ph: (847) 441-5600 |
| NPI Number | 1649806407 |
|---|---|
| Provider Enumeration Date | 03/12/2020 |
| Last Update Date | 03/12/2020 |
| Certification Date | 03/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649806407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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