Organization
CRUSADERS CENTRAL CLINIC ASSOCIATION
Active
Organization
CRUSADERS CENTRAL CLINIC ASSOCIATION
Active
Parent organization
CRUSADERS CENTRAL CLINIC ASSOCIATION
Other names
Crusader Community Health South Beloit Junior High School
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRUSADERS CENTRAL CLINIC ASSOCIATION
Authorized official
SAMUEL MILLER (PRESDIENT & CEO)
(815) 490-1737
Entity
Organization
Contact information
Practice address
840 BLACKHAWK BLVD, SOUTH BELOIT, IL 61080-2263
(815) 490-1600
Mailing address
840 BLACKHAWK BLVD, SOUTH BELOIT, IL 61080-2263
(815) 490-1600
(815) 490-1845
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
07/12/2017
Last updated
08/24/2022
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