| Youth Service Bureau Of Illinois Valley | |
|
308 W State St Rockford IL 61101-1117 | |
| (815) 316-1977 | |
| Not Available |
| Full Name | Youth Service Bureau Of Illinois Valley |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 308 W State St, Rockford, Illinois |
| Authorized Official Name and Position | Lisa Kay Gustafson (TREATMENT COORDINATOR) |
| Authorized Official Contact | 8154333953 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Service Bureau Of Illinois Valley 424 W Madison St Ottawa IL 61350-2833 Ph: (815) 433-3953 | Youth Service Bureau Of Illinois Valley 308 W State St Rockford IL 61101-1117 Ph: (815) 316-1977 |
| NPI Number | 1578808689 |
|---|---|
| Provider Enumeration Date | 11/29/2012 |
| Last Update Date | 09/20/2022 |
| Certification Date | 09/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578808689 | NPI | - | NPPES |
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