| County Of Henry | |
|
110 N Burr Blvd Kewanee IL 61443-2214 | |
| (309) 852-5272 | |
| Not Available |
| Full Name | County Of Henry |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| 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) 852-5272 | County Of Henry 110 N Burr Blvd Kewanee IL 61443-2214 Ph: (309) 852-5272 |
| NPI Number | 1811730492 |
|---|---|
| Provider Enumeration Date | 06/13/2024 |
| Last Update Date | 06/25/2024 |
| Certification Date | 06/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811730492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
Bridgeway Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 137 E College St, Kewanee, IL 61443 Phone: 309-852-4331 | |
Witthouse Holdings Llc 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 | |
Bridgeway, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1220 W Division St, Kewanee, IL 61443 Phone: 309-853-4325 Fax: 309-853-4385 |