JEFFERSON COUNTY COMPREHENSIVE SVC (NPI# 1114216686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114216686 |
| Entity Type | Organization |
| Organization Name | JEFFERSON COUNTY COMPREHENSIVE SVC |
| Practice Address |
Rr 5 Mcleansboro IL 62859 |
| Mailing Address |
Po Box 428 Mount Vernon IL 62864-0054 |
| Practice Telephone | 6182421510 |
| Practice Fax Number | 6182420958 |
| Mailing Telephone | 6182421510 |
| Mailing Fax Number | 6182420958 |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2011-04-05 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881828788 | Jefferson County Comprehensive Svc | Clinic/Center | 16342 N Il Hwy 37, Mt Vernon, IL 62864 | 2009-05-06 |
| Street Address |
RR 5 |
| 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 |
|---|---|---|---|---|
| 1154659886 | Jefferson County Comprehensive Svc Inc | Clinic/Center | Route 14 East, Mcleansboro, IL 62859 | 2009-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639990 | Mindy Forman, Psyd, LLC | Clinic/Center | 1020 Milwaukee Ave Ste 110, Deerfield, IL 60015-3555 | 2020-11-07 |
| 1346840295 | Stopka Professional Counseling LLC | Clinic/Center | 13125 Steeplechase Dr, New Lenox, IL 60451-1320 | 2020-10-29 |
| 1346848785 | Wellness Hearted Therapy LLC | Clinic/Center | 2675 S Cedar Glen Dr, Arlington Heights, IL 60005-5303 | 2020-10-16 |
| 1457959256 | Association for Individual Development | Clinic/Center | 708 N Bridge St, Yorkville, IL 60560-1105 | 2020-10-14 |
| 1285231555 | Association for Individual Development | Clinic/Center | 236 W Crystal Lake Ave, Crystal Lake, IL 60014-5847 | 2020-10-08 |
| 1386241123 | Envision Unlimited | Clinic/Center | 1801 N Spaulding Ave, Chicago, IL 60647-4926 | 2020-10-05 |
| 1881291789 | Jessica Weisbach, LLC | Clinic/Center | 2257 N Kedzie Blvd Apt 3, Chicago, IL 60647-2561 | 2020-10-04 |
| 1619574803 | Envision Unlimited | Clinic/Center | 2124 W 82nd Pl, Chicago, IL 60620-5358 | 2020-10-01 |
| 1144827320 | Envision Unlimited | Clinic/Center | 4919 N Clark St, Chicago, IL 60640-3514 | 2020-10-01 |
| 1194322370 | Envision Unlimited | Clinic/Center | 4911 S Hoyne Ave, Chicago, IL 60609-4721 | 2020-10-01 |
| 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.
| 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.