Organization · Type 2 NPI

Jefferson County Comprehensive

Substance Abuse Rehabilitation Facility · Mount Vernon, IL

NPI number 1649404708 Active

Practice location

16338 N Il Hwy 37
Mount Vernon, IL 62864

Call (618) 242-1994 Map

Fax (618) 242-6392

Mailing address

PO Box 428
Mount Vernon, IL 62864-0054

Specialties and licenses

Taxonomy	Code	License
Community/Behavioral Health Agency	251S00000X	002250003 (IL)
Substance Abuse Rehabilitation Facility Primary	324500000X	002250003 (IL)

Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

5 other providers at this address

Other substance abuse rehabilitation facility providers in Mount Vernon

Jefferson County Comprehensive SVCSubstance Abuse Rehabilitation Facility Mount Vernon, IL NPI 1881828788

See all in Mount Vernon →

NPI record

NPI: 1649404708
Entity type: Organization (Type 2)
Issued: May 5, 2009
Last updated: Aug 17, 2018
Status: Active

Other names

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Substance Abuse Outpatient · other name
Substance Abuse Outpatient · other name

Authorized official

Mr. Daniel P Boehmer, MA, LCPC, QMHP
Executive Director
(618) 242-1994

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1649404708

Jefferson County Comprehensive's National Provider Identifier is 1649404708, issued on May 5, 2009. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Mount Vernon, IL. The record was last updated on Aug 17, 2018.