Youth Service Bureau of Illinois Valley

NPI #1164757266 in Ottawa, Illinois

Provider Information

NPI Number: 1164757266
Entity Type: Organization
Organization Name: Youth Service Bureau of Illinois Valley
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Oct 7, 2009
Last Updated: Sep 20, 2022

Practice Location

Address: 424 W MADISON ST
City: Ottawa
State: Illinois
ZIP Code: 61350-2833
Phone: (815) 433-3953

Authorized Official

Name: MS. LISA KAY GUSTAFSON, M.S.
Title: TREATMENT COORDINATOR
Phone: (815) 431-3022

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community/Behavioral Health	251S00000X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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