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Organization
MATHERS COMMUNITY MENTAL HEALTH CENTER LLC
Active
Organization
MATHERS COMMUNITY MENTAL HEALTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ORALIA CAMPOS (SENIOR BILLING MANAGER)
(815) 444-9999
Entity
Organization
Contact information
Practice address
145 S VIRGINIA ST, CRYSTAL LAKE, IL 60014-7226
(815) 444-9999
Mailing address
145 S VIRGINIA ST, CRYSTAL LAKE, IL 60014-7226
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F100433666
PTAN
IL
Enumeration date
07/07/2016
Last updated
10/26/2018
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