Organization
MARTIN LUTHER KING JR. COMMUNITY SERVICE AREA PROJECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES W COLLINS II REV. (EXECUTIVE DIRECTOR)
(815) 233-9915
Entity
Organization
Contact information
Practice address
555 N COURT ST STE 204, ROCKFORD, IL 61103-6898
(815) 233-9915
(815) 962-2180
Mailing address
555 N COURT ST STE 204, ROCKFORD, IL 61103-6898
(815) 233-9915
(815) 962-2180
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
08002
IL
Other
Enumeration date
03/10/2009
Last updated
03/10/2009
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