Provider Demographics
NPI:1891932570
Name:BOND COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:BOND COUNTY HEALTH DEPARTMENT
Other - Org Name:PRAIRIE COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EIFERT
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:618-664-1442
Mailing Address - Street 1:1520 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62246-2618
Mailing Address - Country:US
Mailing Address - Phone:618-664-1442
Mailing Address - Fax:618-664-1744
Practice Address - Street 1:1520 S 4TH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:IL
Practice Address - Zip Code:62246-2618
Practice Address - Country:US
Practice Address - Phone:618-664-1442
Practice Address - Fax:618-664-1744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL532700Medicare PIN
ILK51361Medicare PIN