Organization
STARVED ROCK FAMILY PSYCHIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA AMITI PMHNP (OWNER)
(815) 275-3035
Entity
Organization
Contact information
Practice address
325 CLARK ST STE C, UTICA, IL 61373-9484
(815) 275-3035
Mailing address
1 BRIDGET TER, UTICA, IL 61373-9552
(815) 275-3035
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/02/2024
Last updated
06/17/2024
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