Provider Demographics
NPI:1780665133
Name:H. DOUGLAS SINGER MENTAL HEALTH CENTER
Entity Type:Organization
Organization Name:H. DOUGLAS SINGER MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOSPITAL ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:YUNUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-987-7778
Mailing Address - Street 1:4402 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61103-1278
Mailing Address - Country:US
Mailing Address - Phone:815-987-7096
Mailing Address - Fax:815-987-7688
Practice Address - Street 1:4402 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61103-1278
Practice Address - Country:US
Practice Address - Phone:815-987-7096
Practice Address - Fax:815-987-7688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital