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Organization

CENTRAL COUNTIES HEALTH CENTERS, INC.

Active
Parent organization
CENTRAL COUNTIES HEALTH CENTERS, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
CENTRAL COUNTIES HEALTH CENTERS, INC.
Authorized official
CINDY KAVANAGH (ACCOUNTANT)
(217) 788-2300
Entity
Organization

Contact information

Practice address
1440 W WALNUT ST, SUITE 2, JACKSONVILLE, IL 62650-1143
(217) 788-2300
(217) 788-2342
Mailing address
2239 E COOK ST, SPRINGFIELD, IL 62703-1944
(217) 788-2300
(217) 788-2342

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
122300000X
Dentist
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
208000000X
Pediatrics Physician
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Enumeration date
05/12/2016
Last updated
05/19/2016
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