# ARROWHEAD RANCH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407026511
- **Authorized official:** DR. CHELEASE MACHAY PARKS ED. D. (DIRECTOR OF STATE PROGRAMS)
- **Authorized official phone:** (309) 799-7044

## Contact information

- **Practice address:** 12200 104TH ST, COAL VALLEY, IL 61240-9712
- **Practice address phone:** (309) 799-7044
- **Mailing address:** 12200 104TH ST, P.O. BOX 370, COAL VALLEY, IL 61240-9712
- **Mailing address phone:** (309) 799-7044

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/04/2008
- **Last updated:** 09/17/2020