Organization
THE BEN GORDON CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETTYBO BIEBERITZ (CONTRACT COORDINATOR)
(815) 756-4875
Entity
Organization
Contact information
Practice address
12 HEALTH SERVICES DR, DEKALB, IL 60115-9637
(815) 756-4875
Mailing address
12 HEALTH SERVICES DR, DEKALB, IL 60115-9637
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/23/2015
Last updated
01/23/2015
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