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Organization
DEKALB BEHAVIORAL HEALTH FOUNDATION, INC.
Active
Organization
DEKALB BEHAVIORAL HEALTH FOUNDATION, INC.
Active
Other names
Northwestern Medicine Ben Gordon Center
Organization subpart
No
Provider details
NPI number
Authorized official
BETTYJO FORTUNE (FINANCIAL ASSESSOR)
(815) 756-4875
Entity
Organization
Contact information
Practice address
12 HEALTH SERVICES DR, DEKALB, IL 60115
(815) 756-4875
Mailing address
PO BOX 1109, DEKALB, IL 60115-7109
(815) 756-4875
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255703450
—
IL
Enumeration date
10/27/2015
Last updated
07/23/2018
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