Provider Demographics
NPI:1114704368
Name:NORTH CENTRAL BEHAVIORAL HEALTH SYSTEMS INC.
Entity Type:Organization
Organization Name:NORTH CENTRAL BEHAVIORAL HEALTH SYSTEMS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:F
Authorized Official - Last Name:BLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-224-5001
Mailing Address - Street 1:P.O. BOX 1488
Mailing Address - Street 2:
Mailing Address - City:LASALLE
Mailing Address - State:IL
Mailing Address - Zip Code:61301
Mailing Address - Country:US
Mailing Address - Phone:815-224-5001
Mailing Address - Fax:
Practice Address - Street 1:2970 CHARTRES ST
Practice Address - Street 2:
Practice Address - City:LA SALLE
Practice Address - State:IL
Practice Address - Zip Code:61301-1097
Practice Address - Country:US
Practice Address - Phone:815-224-5001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)