Organization
COUNTY OF HENRY
Active
Other names
First Choice Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
TARA LAFOLLETTE (CREDENTIALING REPRESENTATIVE)
(309) 852-0197
Entity
Organization
Contact information
Practice address
110 N BURR BLVD, KEWANEE, IL 61443-2214
(309) 852-5272
Mailing address
110 N BURR BLVD, KEWANEE, IL 61443-2214
(309) 852-5272
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/13/2024
Last updated
06/25/2024
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