| Delta Center, Inc | |
|
130 Richland Ter Mounds IL 62964-1233 | |
| (618) 734-2665 | |
| (618) 734-1999 |
| Full Name | Delta Center, Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 130 Richland Ter, Mounds, Illinois |
| Authorized Official Name and Position | Lisa Tolbert (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6187342665 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Delta Center, Inc 130 Richland Ter Mounds IL 62964-1233 Ph: (618) 734-2665 | Delta Center, Inc 130 Richland Ter Mounds IL 62964-1233 Ph: (618) 734-2665 |
| NPI Number | 1972805919 |
|---|---|
| Provider Enumeration Date | 11/24/2010 |
| Last Update Date | 11/24/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972805919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 094500030 (Illinois) | Primary |