Organization · Type 2 NPI
Ten Broeck Tennessee Physicians Group Inc
Adult Mental Health Clinic/Center · Vandalia, IL
NPI number
1083236012
Active
Practice location
802 N 8th St
Vandalia, IL 62471-1756
Fax (618) 283-0590
Mailing address
1 Medical Center Blvd
Cookeville, TN 38501-4294
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Mental Health Clinic/Center Primary | 261QM0850X | None listed |
Adult Mental Health Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
2 other providers at this address
About NPI 1083236012
Ten Broeck Tennessee Physicians Group Inc's National Provider Identifier is 1083236012, issued on May 13, 2020. The primary taxonomy on file is Adult Mental Health Clinic/Center (261QM0850X), and the practice location is in Vandalia, IL. The record was last updated on May 13, 2020.