| Gene A Brodland Lcsw, Llc | |
|
215 S Grand Ave W Springfield IL 62704-3838 | |
| (217) 744-3525 | |
| (217) 744-3535 |
| Full Name | Gene A Brodland Lcsw, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 215 S Grand Ave W, Springfield, Illinois |
| Authorized Official Name and Position | Gene A Brodland (LCSW) |
| Authorized Official Contact | 2177443525 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gene A Brodland Lcsw, Llc 215 S Grand Ave W Springfield IL 62704-3838 Ph: (217) 744-3525 | Gene A Brodland Lcsw, Llc 215 S Grand Ave W Springfield IL 62704-3838 Ph: (217) 744-3525 |
| NPI Number | 1528466430 |
|---|---|
| Provider Enumeration Date | 12/09/2014 |
| Last Update Date | 12/09/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528466430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 149-002608 (Illinois) | Primary |
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