Organization
ROCK RIVER VALLEY MENTAL HEALTH, LLC
Active
Organization
ROCK RIVER VALLEY MENTAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROLYN SUE VAN DOREN PSY. D. (DIRECTOR)
(815) 284-6111
Entity
Organization
Contact information
Practice address
631 WILLETT AVE, DIXON, IL 61021-2348
(815) 284-6111
Mailing address
PO BOX 564, DIXON, IL 61021-0564
(815) 284-6111
(815) 284-6114
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
071.007278
IL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
071.007278
IL
Other
Enumeration date
05/16/2010
Last updated
03/01/2012
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