Organization
BEN GORDON CENTER
Active
Parent organization
BEN GORDON CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEN GORDON CENTER
Authorized official
MICHAEL FLORA (CEO/PRESIDENT)
(815) 756-4875
Entity
Organization
Contact information
Practice address
21193 MALTA RD, BLDG. A - U154, MALTA, IL 60150-9600
(815) 756-4875
(815) 756-2944
Mailing address
21193 MALTA RD, BLDG. A - U154, MALTA, IL 60150-9600
(815) 756-4875
(815) 756-2944
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
A0254001A
IL
Other
Enumeration date
12/17/2010
Last updated
12/17/2010
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