| Harvard | |
|
1475 Harvard Dr # 3 Kankakee IL 60901-8451 | |
| (815) 823-8412 | |
| (815) 823-8431 |
| Full Name | Harvard |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1475 Harvard Dr # 3, Kankakee, Illinois |
| Authorized Official Name and Position | Benjamin Stortz (CEO) |
| Authorized Official Contact | 8157417045 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Harvard 1475 Harvard Dr # 3 Kankakee IL 60901-8451 Ph: (815) 823-8412 | Harvard 1475 Harvard Dr # 3 Kankakee IL 60901-8451 Ph: (815) 823-8412 |
| NPI Number | 1053746388 |
|---|---|
| Provider Enumeration Date | 09/05/2013 |
| Last Update Date | 06/22/2021 |
| Certification Date | 06/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053746388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | () | Primary |
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