Tazwood Mental Health Center, Inc. | |
124 S Chicago St Lincoln IL 62656-2719 | |
(217) 732-6865 | |
Not Available |
Full Name | Tazwood Mental Health Center, Inc. |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 124 S Chicago St, Lincoln, Illinois |
Authorized Official Name and Position | David Mingus (CEO) |
Authorized Official Contact | 3093475579 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Tazwood Mental Health Center, Inc. 3248 Vandever Ave Pekin IL 61554-6257 Ph: (309) 477-5552 | Tazwood Mental Health Center, Inc. 124 S Chicago St Lincoln IL 62656-2719 Ph: (217) 732-6865 |
NPI Number | 1760958797 |
---|---|
Provider Enumeration Date | 10/17/2018 |
Last Update Date | 10/17/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760958797 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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Tazwood Mental Health Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 124-126 S. Chicago Street, Lincoln, IL 62656 Phone: 217-732-6865 Fax: 217-732-7845 | |
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