Organization
FAMILY COUNSELING CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA PICKERING (COMPUTER BILLING)
(618) 658-2611
Entity
Organization
Contact information
Practice address
125 N MARKET ST, GOLCONDA, IL 62938-1136
(618) 683-2461
Mailing address
125 N MARKET ST, GOLCONDA, IL 62938-1136
(618) 683-2461
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
04055
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T5DDRTQE99C0
HFS ID NUMBER
IL
Enumeration date
08/23/2011
Last updated
08/23/2011
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