| County Of Henry | |
|
110 N Burr Blvd Kewanee IL 61443-2214 | |
| (309) 852-0197 | |
| Not Available |
| Full Name | County Of Henry |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 110 N Burr Blvd, Kewanee, Illinois |
| Authorized Official Name and Position | Tara Lafollette (CREDENTIALING REPRESENTATIVE) |
| Authorized Official Contact | 3098520197 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| County Of Henry 110 N Burr Blvd Kewanee IL 61443-2214 Ph: (309) 852-0197 | County Of Henry 110 N Burr Blvd Kewanee IL 61443-2214 Ph: (309) 852-0197 |
| NPI Number | 1487361200 |
|---|---|
| Provider Enumeration Date | 11/01/2022 |
| Last Update Date | 11/01/2022 |
| Certification Date | 11/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487361200 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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Witthouse Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 N Tremont St, Kewanee, IL 61443 Phone: 815-531-2803 | |
Illinois Medicaid- Substance Abuse Kewanee Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 137 E College St, Kewanee, IL 61443 Phone: 309-852-4331 | |
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