| Average Joe Psychiatric Services, Pllc | |
|
220 Red Bud Dr Mahomet IL 61853-9604 | |
| (217) 714-1006 | |
| Not Available |
| Full Name | Average Joe Psychiatric Services, Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 220 Red Bud Dr, Mahomet, Illinois |
| Authorized Official Name and Position | Daniel T Foutch (CEO) |
| Authorized Official Contact | 2177141006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Average Joe Psychiatric Services, Pllc 220 Red Bud Dr Mahomet IL 61853-9604 Ph: (217) 714-1006 | Average Joe Psychiatric Services, Pllc 220 Red Bud Dr Mahomet IL 61853-9604 Ph: (217) 714-1006 |
| NPI Number | 1932906005 |
|---|---|
| Provider Enumeration Date | 02/26/2025 |
| Last Update Date | 02/26/2025 |
| Certification Date | 02/26/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932906005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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