Provider Demographics
NPI:1649248113
Name:BEHAVIORAL HEALTH ADVANTAGES, INC.
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH ADVANTAGES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P., COO
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:AFFOLTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-589-1011
Mailing Address - Street 1:7210 N. VILLA LAKE DR.
Mailing Address - Street 2:SUITE D
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-8235
Mailing Address - Country:US
Mailing Address - Phone:309-589-1011
Mailing Address - Fax:309-589-1019
Practice Address - Street 1:7210 N. VILLA LAKE DR.
Practice Address - Street 2:SUITE D
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-8235
Practice Address - Country:US
Practice Address - Phone:309-589-1011
Practice Address - Fax:309-589-1019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty