Organization
BEN GORDON CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL D FLORA (PRESIDENT CEO)
(815) 756-4875
Entity
Organization
Contact information
Practice address
12 HEALTH SERVICES DRIVE, DEKALB, IL 60115
(815) 756-4875
(815) 756-2944
Mailing address
12 HEALTH SERVICES DRIVE, DEKALB, IL 60115
(815) 756-4875
(815) 756-2944
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
A0254001A
IL
Other
Enumeration date
06/22/2006
Last updated
04/20/2008
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