Provider Demographics
NPI:1558910794
Name:MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS
Entity Type:Organization
Organization Name:MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-588-2626
Mailing Address - Street 1:303 E BIDWELL ST
Mailing Address - Street 2:
Mailing Address - City:TAYLORVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62568-1363
Mailing Address - Country:US
Mailing Address - Phone:217-525-1064
Mailing Address - Fax:217-525-1651
Practice Address - Street 1:303 E BIDWELL ST
Practice Address - Street 2:
Practice Address - City:TAYLORVILLE
Practice Address - State:IL
Practice Address - Zip Code:62568-1363
Practice Address - Country:US
Practice Address - Phone:217-525-1064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-10
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)