Provider Demographics
NPI:1356460125
Name:SCHUYLER COUNTY MENTAL HEALTH ASSOCIATION
Entity Type:Organization
Organization Name:SCHUYLER COUNTY MENTAL HEALTH ASSOCIATION
Other - Org Name:SCHUYLER COUNSELING AND HEALTH SERVCIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:REGGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STAMBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-322-4373
Mailing Address - Street 1:127 S LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62681-1419
Mailing Address - Country:US
Mailing Address - Phone:217-322-4373
Mailing Address - Fax:217-322-2138
Practice Address - Street 1:127 S LIBERTY ST
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IL
Practice Address - Zip Code:62681-1419
Practice Address - Country:US
Practice Address - Phone:217-322-4373
Practice Address - Fax:217-322-2138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251E00000XAgenciesHome Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL774420Medicare ID - Type Unspecified