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Organization
GRUNDY EUNOIA WELLNESS CENTER NFP
Active
Organization
GRUNDY EUNOIA WELLNESS CENTER NFP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PARKER (BILLING ADMINISTRATOR)
(815) 513-3654
Entity
Organization
Contact information
Practice address
606 DEPOT ST, MAZON, IL 60444-3703
(815) 513-3654
Mailing address
PO BOX 74, MAZON, IL 60444-0074
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
07/09/2024
Last updated
06/18/2025
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