# COUNTY OF HENRY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COUNTY OF HENRY
- **Other names:** First Choice Healthcare
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1265066625
- **Legal business name:** COUNTY OF HENRY
- **Authorized official:** TARA LAFOLLETTE (CREDENTIALING REPRESENTATIVE)
- **Authorized official phone:** (309) 852-0197

## Contact information

- **Practice address:** 110 N BURR BLVD, KEWANEE, IL 61443-2214
- **Practice address phone:** (309) 852-0197
- **Practice address fax:** (309) 852-0595
- **Mailing address:** 110 N BURR BLVD, KEWANEE, IL 61443-2214
- **Mailing address phone:** (309) 852-0197
- **Mailing address fax:** (309) 852-0595

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/25/2020
- **Last updated:** 02/25/2020