Organization · Type 2 NPI
Supported Residential
Mental Health Clinic/Center (Including Community Mental Health Center) · Bloomington, IL
NPI number
1578266342
Active
Practice location
710 W Mulberry St
Bloomington, IL 61701-2868
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) Primary | 261QM0801X | None listed |
Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...
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About NPI 1578266342
Supported Residential's National Provider Identifier is 1578266342, issued on Mar 22, 2023. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Bloomington, IL. The record was last updated on Mar 22, 2023.