| Memorial Behavioral Health - Jacksonville | |
|
340 W State St Jacksonville IL 62650 | |
| (217) 245-6126 | |
| (217) 245-4296 |
| Full Name | Memorial Behavioral Health - Jacksonville |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 340 W State St, Jacksonville, Illinois |
| Authorized Official Name and Position | Ann Bowling (DIRECTOR) |
| Authorized Official Contact | 2175882626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Memorial Behavioral Health - Jacksonville 340 W State St Jacksonville IL 62650-2061 Ph: (217) 245-6126 | Memorial Behavioral Health - Jacksonville 340 W State St Jacksonville IL 62650 Ph: (217) 245-6126 |
| NPI Number | 1225282999 |
|---|---|
| Provider Enumeration Date | 11/07/2008 |
| Last Update Date | 10/31/2023 |
| Certification Date | 10/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225282999 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Illinois) | Primary |
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