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Organization

CENTRAL COUNTIES HEALTH CENTERS, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CINDY KAVANAGH (ACCOUNTANT)
(217) 788-2300
Entity
Organization

Contact information

Practice address
221 N 11TH ST, HCH - SALVATION ARMY - 6TH ST., SPRINGFIELD, IL 62703-1003
(217) 788-2300
(217) 788-2343
Mailing address
2239 E COOK ST, HCH - SALVATION ARMY 6TH, SPRINGFIELD, IL 62703-1944
(217) 788-2300
(217) 788-2343

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
208000000X
Pediatrics Physician
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Enumeration date
01/08/2007
Last updated
11/10/2015
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