Organization
CENTRAL COUNTIES HEALTH CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY KAVANAGH (ACCOUNTANT)
(217) 788-2300
Entity
Organization
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62702-5324
(217) 788-2300
Mailing address
2239 E COOK ST, SPRINGFIELD, IL 62703-1944
(217) 788-2300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/12/2016
Last updated
10/12/2016
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