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Organization
ARROWHEAD RANCH
Active
Organization
ARROWHEAD RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHELEASE MACHAY PARKS ED. D. (DIRECTOR OF STATE PROGRAMS)
(309) 799-7044
Entity
Organization
Contact information
Practice address
12200 104TH ST, COAL VALLEY, IL 61240-9712
(309) 799-7044
Mailing address
12200 104TH ST, P.O. BOX 370, COAL VALLEY, IL 61240-9712
(309) 799-7044
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
NULL
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
03/04/2008
Last updated
09/17/2020
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