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Organization
FAMILY SERVICE AGENCY OF DEKALB COUNTY, INC.
Active
Organization
FAMILY SERVICE AGENCY OF DEKALB COUNTY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYNISHA CLEGG (DIRECTOR OF OPERATIONS)
(815) 758-8616
Entity
Organization
Contact information
Practice address
1325 SYCAMORE RD, DEKALB, IL 60115-2483
(815) 758-8616
Mailing address
1325 SYCAMORE RD, DEKALB, IL 60115-2483
(815) 758-8616
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
17004
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17004
—
IL
Enumeration date
06/13/2017
Last updated
11/17/2023
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