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Organization
A & E BEHAVIORAL HEALTH CARE ASSOCIATES PC
Active
Organization
A & E BEHAVIORAL HEALTH CARE ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INDIGO BUTT (BILLING DEPARTMENT)
(217) 872-1003
Entity
Organization
Contact information
Practice address
2570 FEDERAL DRIVE, DECATUR, IL 62526
(217) 872-1003
(217) 233-4150
Mailing address
2570 FEDERAL DRIVE, DECATUR, IL 62526
(217) 872-1003
(217) 233-4150
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
IL
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05821971
BCBS
IL
Enumeration date
12/19/2006
Last updated
08/03/2009
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