Organization
CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION
Active
Other names
CCMHA
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA A CARROLL (BILLING SUPERVISOR)
(217) 824-4905
Entity
Organization
Contact information
Practice address
703 MCADAM DR, TAYLORVILLE, IL 62568-2300
(217) 824-4905
(217) 824-3570
Mailing address
PO BOX 438, TAYLORVILLE, IL 62568-0438
(217) 824-4905
(217) 824-3570
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04025
—
IL
Enumeration date
03/07/2016
Last updated
03/07/2016
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