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Organization
BEN GORDON CENTER
Active
Organization
BEN GORDON CENTER
Active
Parent organization
BEN GORDON CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEN GORDON CENTER
Authorized official
MICHAEL FLORA (CEO/PRESIDENT)
(815) 756-4875
Entity
Organization
Contact information
Practice address
21193 MALTA RD, BLDG. A - U154, MALTA, IL 60150-9600
(815) 756-4875
(815) 756-2944
Mailing address
21193 MALTA RD, BLDG. A - U154, MALTA, IL 60150-9600
(815) 756-4875
(815) 756-2944
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
A0254001A
IL
Other
Enumeration date
12/17/2010
Last updated
12/17/2010
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