Organization
EGYPTIAN HEALTH DEPARTMENT
Active
Other names
Egyptian Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE HAMPTON (CEO)
(618) 273-3326
Entity
Organization
Contact information
Practice address
407 N BASIN RD, FAIRFIELD, IL 62837-9639
(618) 273-3326
(618) 273-2808
Mailing address
1412 US HIGHWAY 45 N, ELDORADO, IL 62930-3766
(618) 273-3326
(618) 273-3585
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04051
—
IL
Enumeration date
11/01/2018
Last updated
05/28/2020
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