Provider Demographics
NPI:1891034906
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:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:815-224-5001
Mailing Address - Street 1:120 E COURT ST
Mailing Address - Street 2:
Mailing Address - City:TOULON
Mailing Address - State:IL
Mailing Address - Zip Code:61483-5388
Mailing Address - Country:US
Mailing Address - Phone:815-223-0160
Mailing Address - Fax:815-223-1634
Practice Address - Street 1:120 E COURT ST
Practice Address - Street 2:
Practice Address - City:TOULON
Practice Address - State:IL
Practice Address - Zip Code:61483-5388
Practice Address - Country:US
Practice Address - Phone:815-223-0160
Practice Address - Fax:815-223-1634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)