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Organization

A & E BEHAVIORAL HEALTH CARE ASSOCIATES PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
INDIGO BUTT (BILLING DEPARTMENT)
(217) 872-1003
Entity
Organization

Contact information

Practice address
2570 FEDERAL DRIVE, DECATUR, IL 62526
(217) 872-1003
(217) 233-4150
Mailing address
2570 FEDERAL DRIVE, DECATUR, IL 62526
(217) 872-1003
(217) 233-4150

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
IL
101Y00000X
Counselor
103T00000X
Psychologist
104100000X
Social Worker
2084P0800X
Psychiatry Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05821971
BCBS
IL
Enumeration date
12/19/2006
Last updated
08/03/2009
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