Provider Demographics
NPI:1942316179
Name:CASS COUNTY MENTAL HEALTH ASSOC
Entity Type:Organization
Organization Name:CASS COUNTY MENTAL HEALTH ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AND CLAIMS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BECHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-323-2980
Mailing Address - Street 1:121 E 2ND STREET
Mailing Address - Street 2:
Mailing Address - City:BEARDSTOWN
Mailing Address - State:IL
Mailing Address - Zip Code:62618
Mailing Address - Country:US
Mailing Address - Phone:217-323-2980
Mailing Address - Fax:217-323-3731
Practice Address - Street 1:121 E 2ND STREET
Practice Address - Street 2:
Practice Address - City:BEARDSTOWN
Practice Address - State:IL
Practice Address - Zip Code:62618
Practice Address - Country:US
Practice Address - Phone:217-323-2980
Practice Address - Fax:217-323-3731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
932002OtherBLUE CROSS BLUE SHIELD
IL036075498Medicaid
IL036075498Medicaid