Provider Demographics
NPI:1679123954
Name:DOUGLAS COUNTY MENTAL HEALTH AND FAMILY COUNSELING ASSOCIATION INC.
Entity type:Organization
Organization Name:DOUGLAS COUNTY MENTAL HEALTH AND FAMILY COUNSELING ASSOCIATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-253-4731
Mailing Address - Street 1:114 W HOUGHTON ST
Mailing Address - Street 2:
Mailing Address - City:TUSCOLA
Mailing Address - State:IL
Mailing Address - Zip Code:61953-1660
Mailing Address - Country:US
Mailing Address - Phone:217-253-4731
Mailing Address - Fax:217-253-4733
Practice Address - Street 1:114 W HOUGHTON ST
Practice Address - Street 2:
Practice Address - City:TUSCOLA
Practice Address - State:IL
Practice Address - Zip Code:61953-1660
Practice Address - Country:US
Practice Address - Phone:217-253-4731
Practice Address - Fax:217-253-4733
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOUGLAS COUNTY MENTAL HEALTH AND FAMILY COUNSELING ASSOCIATION INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility