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NORTH CENTRAL BEHAVIORAL HEALTH SYSTEMS INC. NPI 1780108985


NPI Information

NPI: 1780108985
Provider Name: NORTH CENTRAL BEHAVIORAL HEALTH SYSTEMS, INC.

Former Legal Business Name: NORTH CENTRAL STRETOR DMH MEDICAID

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
111 SPRING ST STE 320-328
STREATOR, IL
ZIP 61364
Phone: (815) 223-0160
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NORTH CENTRAL BEHAVIORAL HEALTH SYSTEMS, INC. is a mental health (including community mental health center) clinic center in Streator, IL. NORTH CENTRAL BEHAVIORAL HEALTH SYSTEMS, INC. NPI is 1780108985. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is North Central Stretor Dmh Medicaid.

The provider's business location address is:

111 SPRING ST STE 320-328
STREATOR, IL
ZIP 61364-332
Phone: (815) 223-0160

The provider's authorized official is Larry Block .
The authorized official title is Cfo and has the following contact phone number (815) 224-5001.

The enumeration date for this NPI number is 7/29/2017 and was last updated on 3/13/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)04107ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
104107MEDICAIDILLINOIS

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: 4/28/2024

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