NORTH CENTRAL BEHAVIORAL HEALTH SYSTEMS, INC. (NPI# 1780108985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780108985 |
| Entity Type | Organization |
| Organization Name | NORTH CENTRAL BEHAVIORAL HEALTH SYSTEMS, INC. |
| Other Organization Name | NORTH CENTRAL STRETOR DMH MEDICAID |
| Practice Address |
111 Spring St Ste 320-328 Streator IL 61364-3332 |
| Mailing Address |
Po Box 1488 La Salle IL 61301-3488 |
| Practice Telephone | 8152230160 |
| Mailing Telephone | 8152230160 |
| Mailing Fax Number | 8152231634 |
| Enumeration Date | 2017-07-29 |
| Last Update Date | 2020-03-13 |
| Authorized Official Name | LARRY BLOCK (CFO) |
| Authorized Official Telephone | 8152245001 |
| Authorized Official Credential | CPA |
| 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) |
04107 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 04107 | 05 |
| Other Name | Type Code |
|---|---|
| North Central Stretor DMH Medicaid | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124531322 | North Central Behavioral Health Systems, Inc. | Clinic/Center | 530 Park Ave E Ste 206b, Princeton, IL 61356-3902 | 2017-11-09 |
| 1134249550 | North Central Behavioral Health Systems, Inc. | Clinic/Center | 727 Etna Rd., Ottawa, IL 61350 | 2007-03-30 |
| 1407976285 | North Central Behavioral Health Systems, Inc. | Clinic/Center | 229 Martin Ave, Canton, IL 61520-2520 | 2007-03-29 |
| 1528188380 | North Central Behavioral Health Systems, Inc. | Clinic/Center | 17 Northpoint Dr, Streator, IL 61364-1159 | 2007-03-29 |
| 1851804058 | North Central Behavioral Health Systems, Inc. | Clinic/Center | 530 Park Ave E Ste 206b, Princeton, IL 61356-3902 | 2017-11-09 |
| 1205345766 | North Central Behavioral Health Systems, Inc. | Clinic/Center | 111 Spring St Ste 28, Streator, IL 61364-3332 | 2017-09-27 |
| 1891034906 | North Central Behavioral Health Systems, Inc. | Clinic/Center | 120 E Court St, Toulon, IL 61483-5388 | 2013-02-08 |
| 1073633418 | North Central Behavioral Health Systems, Inc. | Clinic/Center | 727 E Etna Rd, Ottawa, IL 61350-1040 | 2007-03-30 |
| 1982724324 | North Central Behavioral Health Systems, Inc. | Clinic/Center | 526 S Bureau Valley Pkwy, Perry Plaza, Princeton, IL 61356-2046 | 2007-03-30 |
| 1790805133 | North Central Behavioral Health Systems, Inc. | Clinic/Center | 526 S Bureau Valley Pkwy, Perry Plaza, Princeton, IL 61356-2046 | 2007-03-30 |
| Street Address |
111 SPRING ST STE 320-328 |
| City | STREATOR |
| State | IL |
| Zip Code | 61364-3332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891327144 | North Central Behavioral Health Systems, Inc | Clinic/Center | 111 Spring St Ste 320-328, Streator, IL 61364-3332 | 2020-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093110066 | Ottawa Friendship House Work Activity Center, Inc | Intermediate Care Facility, Mentally Retarded | 600 West 12th Street, Streator, IL 61364 | 2014-11-03 |
| 1306278973 | Robert Henry Harms | Veterinarian | 701 Oakley Ave, Streator, IL 61364 | 2013-08-06 |
| 1518202373 | Jessica L Hartman | Nurse Practitioner | 2377 N Bloomington St, Streator, IL 61364 | 2012-12-05 |
| 1992049563 | Wendell Allen Sargent | Dentist | 106 Boys St, Streator, IL 61364 | 2012-11-20 |
| 1215266036 | Sudha Pravinkumar | Internal Medicine | 2377 Bloomington Ave, Ste B, Streator, IL 61364 | 2009-12-08 |
| 1497988984 | Lifetime Medical Supply Inc. | Durable Medical Equipment & Medical Supplies | 1215 N Ottercreek Rd., Streator, IL 61364 | 2009-08-31 |
| 1275709727 | Fresenius Medical Care of Illinois LLC | Clinic/Center | 2356 North Bloomington St, Streator, IL 61364 | 2008-05-05 |
| 1487701793 | Tammy R Thieme | Social Worker | 17 North Point Plaza, Streator, IL 61364 | 2007-01-05 |
| 1629185376 | Gary Finkelstein Md Eye Associates Sc | Ophthalmology | 102 West Elm Street, Streator, IL 61364 | 2006-08-25 |
| 1134150808 | Indra Pal Mdsc | Internal Medicine | 104 Sixth Street, Streator, IL 61364 | 2006-07-05 |
| Find all providers in zip 61364 | ||||
| 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 |
|---|---|---|---|---|
| 1346870367 | North Central Behavioral Health Systems Inc. | Clinic/Center | 111 Spring St Ste 320, Streator, IL 61364-3332 | 2020-01-17 |
| 1528188380 | North Central Behavioral Health Systems, Inc. | Clinic/Center | 17 Northpoint Dr, Streator, IL 61364-1159 | 2007-03-29 |
| 1205345766 | North Central Behavioral Health Systems, Inc. | Clinic/Center | 111 Spring St Ste 28, Streator, IL 61364-3332 | 2017-09-27 |
| 1548380975 | North Central Behavioral Health Systems Inc. | Clinic/Center | 17 Northpoint Dr, Streator, IL 61364-1159 | 2007-03-30 |
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| 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.