# NATIONAL HEALTHCARE OF MT VERNON INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Crossroads Family Medicine of Benton
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982955712
- **Authorized official:** TARA P RICHARDSON (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (615) 221-3672

## Contact information

- **Practice address:** 905 W WASHINGTON ST STE A, BENTON, IL 62812
- **Practice address phone:** (618) 435-2229
- **Mailing address:** PO BOX 689022, FRANKLIN, TN 37068-9022
- **Mailing address phone:** (800) 709-7338
- **Mailing address fax:** (615) 469-6505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | 0003947 | IL | Yes |

## Other

- **Enumeration date:** 09/19/2012
- **Last updated:** 04/23/2019