TEN BROECK TENNESSEE PHYSICIANS GROUP INC NPI 1083236012

NPI Information

NPI: 1083236012
Provider Name: TEN BROECK TENNESSEE PHYSICIANS GROUP INC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
802 N 8TH ST
VANDALIA, IL
ZIP 62471
Phone: (618) 283-1731
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TEN BROECK TENNESSEE PHYSICIANS GROUP INC is an adult mental health clinic center in Vandalia, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. TEN BROECK TENNESSEE PHYSICIANS GROUP INC NPI is 1083236012. The provider is registered as an organization entity type.

The provider's business location address is:

802 N 8TH ST
VANDALIA, IL
ZIP 62471-756
Phone: (618) 283-1731
Fax: (618) 283-0590

The provider's authorized official is Glenda F Guy .
The authorized official title is Director, Compliance and has the following contact phone number (931) 783-2511.

The enumeration date for this NPI number is 5/13/2020 and was last updated on 5/13/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0850X	Clinic/Center	Adult Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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