GALENA CLINIC, INC. (NPI# 1073067138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073067138 |
| Entity Type | Organization |
| Organization Name | GALENA CLINIC, INC. |
| Practice Address |
939 Galena Square Dr Galena IL 61036 |
| Mailing Address |
939 Galena Square Dr Galena IL 61036-1355 |
| Practice Telephone | 8157771300 |
| Practice Fax Number | 8157771308 |
| Mailing Telephone | 8157771300 |
| Mailing Fax Number | 8157771308 |
| Enumeration Date | 2016-08-06 |
| Last Update Date | 2018-06-05 |
| Authorized Official Name | DR. KENNETH DAVIS (PRESIDENT) |
| Authorized Official Telephone | 8157771300 |
| Authorized Official Credential | M.D., PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
14011 | IL | Ambulatory Health Care Facilities |
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
14011 | IL | Ambulatory Health Care Facilities |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
14011 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MENTAL HEALTH | 14011 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033408356 | Galena Clinic, Inc. | Community/Behavioral Health | 939 Galena Square Dr, Galena, IL 61036-1355 | 2011-04-07 |
| Street Address |
939 GALENA SQUARE DR |
| City | GALENA |
| State | IL |
| Zip Code | 61036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033408356 | Galena Clinic, Inc. | Community/Behavioral Health | 939 Galena Square Dr, Galena, IL 61036-1355 | 2011-04-07 |
| 1609499318 | Paul Andrew Gutowski | Counselor | 939 Galena Square Dr, Galena, IL 61036-1355 | 2020-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194371104 | Pamela Sue Fassbinder | Clinical Nurse Specialist | 939 Galena Square Drive, Galena, IL 61036 | 2019-08-15 |
| 1770061871 | Michelle C Frangella Finley | Emergency Medical Technician, Basic | 217 Summit Street, Galena, IL 61036 | 2018-07-31 |
| 1588180897 | Erin Einsweiler Soat | Speech-Language Pathologist | 219 Kelly Lane, Galena, IL 61036 | 2017-08-17 |
| 1023427713 | Stephanie Cocagne | Counselor | 412 1/2 S Main Street, Unit 202, Galena, IL 61036 | 2014-08-06 |
| 1134458474 | Rebecca Ann Rosenthal | Chiropractor | 202 Summit Street, Galena, IL 61036 | 2009-12-16 |
| 1144474339 | Scott Richard Schaber | Physical Therapist | 10988 Bartell Blvd., Galena, IL 61036 | 2008-11-14 |
| 1326268327 | Jdwi | Clinic/Center | 706 West St, Galena, IL 61036 | 2007-05-01 |
| 1639213309 | Kelly Sue Kent | Speech-Language Pathologist | 706 S West Street, Galena, IL 61036 | 2007-02-16 |
| 1447391750 | Gregg Lee Painter | Dentist | 202 Summit St, Galena, IL 61036 | 2007-02-09 |
| 1962476119 | Galena Area Emergency Medical Service District | Ambulance | 217 Summit St, Galena, IL 61036 | 2006-02-15 |
| Find all providers in zip 61036 | ||||
| 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 |
|---|---|---|---|---|
| 1679615363 | Jane Addams Comm Mental Health Center | Clinic/Center | 300 Summit St, Galena, IL 61036-1638 | 2007-02-12 |
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|---|---|---|---|---|
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| Find all providers with the same taxonomy | ||||
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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.