Provider Demographics
NPI:1356717391
Name:ARROWLEAF
Entity type:Organization
Organization Name:ARROWLEAF
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:K
Authorized Official - Last Name:COWSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-652-2046
Mailing Address - Street 1:PO BOX 759
Mailing Address - Street 2:
Mailing Address - City:GOLCONDA
Mailing Address - State:IL
Mailing Address - Zip Code:62938-0759
Mailing Address - Country:US
Mailing Address - Phone:618-683-2461
Mailing Address - Fax:
Practice Address - Street 1:1401 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:IL
Practice Address - Zip Code:62914-1810
Practice Address - Country:US
Practice Address - Phone:618-734-2665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-13
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)