| Jefferson County Comprehensive | |
|
16338 N Il Hwy 37 Mt Vernon IL 62864 | |
| (618) 242-1994 | |
| (618) 242-6392 |
| Full Name | Jefferson County Comprehensive |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 16338 N Il Hwy 37, Mt Vernon, Illinois |
| Authorized Official Name and Position | Daniel P Boehmer (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6182421994 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson County Comprehensive Po Box 428 Mount Vernon IL 62864-0054 Ph: (618) 242-1994 | Jefferson County Comprehensive 16338 N Il Hwy 37 Mt Vernon IL 62864 Ph: (618) 242-1994 |
| NPI Number | 1649404708 |
|---|---|
| Provider Enumeration Date | 05/05/2009 |
| Last Update Date | 08/17/2018 |
| Medicare PECOS PAC ID | 1153350103 |
|---|---|
| Medicare Enrollment ID | O20050810000128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649404708 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 002250003 (Illinois) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | 002250003 (Illinois) | Primary |
| Provider Name | Angela D Betters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295442325 PECOS PAC ID: 8820451263 Enrollment ID: I20230831003369 |
| Provider Name | Larry W Knopp |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679595458 PECOS PAC ID: 0840723862 Enrollment ID: I20241030000555 |
Christopher Greater Area Rural Health Planning Corporation Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2920 Veterans Parkway, Mt Vernon, IL 62864 Phone: 618-244-6544 Fax: 618-244-6577 | |
Lutheran Child And Family Service Of Illinois Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 618 S. 42nd St, Mt Vernon, IL 62864 Phone: 618-242-3284 Fax: 618-242-3288 | |
Jefferson County Comprehensive Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 16342 N Il Hwy 37, Mt Vernon, IL 62864 Phone: 618-242-1510 Fax: 618-242-0958 |