JEFFERSON COUNTY COMPREHENSIVE SVC INC (NPI# 1154659886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154659886 |
| Entity Type | Organization |
| Organization Name | JEFFERSON COUNTY COMPREHENSIVE SVC INC |
| Practice Address |
Route 14 East Mcleansboro IL 62859 |
| Mailing Address |
P O Box 295 Route 14 East Mcleansboro IL 62859 |
| Practice Telephone | 6182421510 |
| Practice Fax Number | 6182420958 |
| Mailing Telephone | 6182421510 |
| Mailing Fax Number | 6182420958 |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2009-11-18 |
| Authorized Official Name | DANIEL P BOEHMER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6182421994 |
| Authorized Official Credential | MA, LCPC, QMHP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
04083 | IL | Ambulatory Health Care Facilities |
| Street Address |
ROUTE 14 EAST |
| City | MCLEANSBORO |
| State | IL |
| Zip Code | 62859 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639598220 | Emily Knight | Speech-Language Pathologist | 10499 County Rd. 700 N., Mc Leansboro, IL 62859 | 2014-04-10 |
| 1235422130 | Hamilton Memorial Nursing and Rehabilitation Center, L.L.C. | Skilled Nursing Facility | 609 S Marshall Avenue, Mcleansboro, IL 62859 | 2011-05-25 |
| 1558673152 | Sai Prashanth Babu Palepu | Family Medicine | 611 South Marshall, Mcleansboro, IL 62859 | 2010-07-12 |
| 1831329416 | Nikki Diane Lynch | Occupational Therapy Assistant | Rr3 Box 108, Mcleansboro, IL 62859 | 2009-07-17 |
| 1952576639 | Rci Wrs Inc | Clinic/Center | 208 B South Washington Street, Mcleansboro, IL 62859 | 2008-04-24 |
| 1215110903 | Hamilton County Health Department | Clinic/Center | Courthouse Room 5, Mcleansboro, IL 62859 | 2007-12-17 |
| 1366504888 | Crossroads Physician Corp | Physician Assistant | 208 S Washington Street, Mcleansboro, IL 62859 | 2006-12-14 |
| 1033291034 | Brett Allen Watkins | Chiropractor | 301 S Jackson, Mcleansboro, IL 62859 | 2006-10-19 |
| 1609837665 | Hamilton Memorial Hospital District | Clinic/Center | 611 S Marshall Avenue, Mcleansboro, IL 62859 | 2006-03-30 |
| 1437650116 | Deaconess Specialty Physicians, Inc | Internal Medicine | 206 S Washington St, Mc Leansboro, IL 62859 | 2018-02-27 |
| Find all providers in zip 62859 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114216686 | Jefferson County Comprehensive Svc | Clinic/Center | Rr 5, Mcleansboro, IL 62859 | 2011-04-05 |
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|---|---|---|---|---|
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| 1881291789 | Jessica Weisbach, LLC | Clinic/Center | 2257 N Kedzie Blvd Apt 3, Chicago, IL 60647-2561 | 2020-10-04 |
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| Find all providers with the same taxonomy | ||||
| City | MCLEANSBORO |
| Zip Code | 62859 |
Please comment or provide details below to improve the information on JEFFERSON COUNTY COMPREHENSIVE SVC INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.