Organization
FAMILY SERVICE AGENCY OF DEKALB COUNTY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYNISHA CLEGG (DIRECTOR OF OPERATIONS)
(815) 758-8616
Entity
Organization
Contact information
Practice address
1325 SYCAMORE RD, DEKALB, IL 60115-2483
(815) 758-8616
Mailing address
1325 SYCAMORE RD, DEKALB, IL 60115-2483
(815) 758-8616
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
17004
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17004
—
IL
Enumeration date
06/13/2017
Last updated
11/17/2023
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