Provider Demographics
NPI:1659855997
Name:STEADFAST CENTER LLC
Entity Type:Organization
Organization Name:STEADFAST CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:217-778-4134
Mailing Address - Street 1:701 DEVONSHIRE DR STE B1
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-7337
Mailing Address - Country:US
Mailing Address - Phone:217-778-4134
Mailing Address - Fax:
Practice Address - Street 1:701 DEVONSHIRE DR STE B1
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-7337
Practice Address - Country:US
Practice Address - Phone:217-778-4134
Practice Address - Fax:844-450-1518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-22
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty