YOUTH SERVICE BUREAU OF ILLINOIS VALLEY NPI 1578808689

NPI Information

NPI: 1578808689
Provider Name: YOUTH SERVICE BUREAU OF ILLINOIS VALLEY
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
308 W STATE ST
ROCKFORD, IL
ZIP 61101
Phone: (815) 316-1977
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YOUTH SERVICE BUREAU OF ILLINOIS VALLEY is a mental health (including community mental health center) clinic center in Rockford, IL. YOUTH SERVICE BUREAU OF ILLINOIS VALLEY NPI is 1578808689. The provider is registered as an organization entity type.

The provider's business location address is:

308 W STATE ST
ROCKFORD, IL
ZIP 61101-117
Phone: (815) 316-1977

The provider's authorized official is Lisa Kay Gustafson .
The authorized official title is Treatment Coordinator and has the following contact phone number (815) 433-3953.

The enumeration date for this NPI number is 11/29/2012 and was last updated on 5/4/2021.

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	251S00000X	Community/Behavioral Health		1041C0700X	ILLINOIS	No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			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: 11/14/2023

NPI Synchronization or Removal

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