Organization
JANET WATTLES CENTER
Active
Other names
Manhattan Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHIL EATON (CEO/PRESIDENT)
(815) 968-9300
Entity
Organization
Contact information
Practice address
526 W STATE ST, ROCKFORD, IL 61101-1214
(815) 968-9300
(815) 968-5314
Mailing address
526 W STATE ST, ROCKFORD, IL 61101-1214
(815) 968-9300
(815) 968-5314
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BLUE CROSS
10120962
—
Enumeration date
04/26/2006
Last updated
06/14/2011
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