1402 Cockrell LLC
NPI #1184590747 in Springfield, Illinois
Provider Information
- NPI Number
- 1184590747
- Entity Type
- Organization
- Organization Name
- 1402 Cockrell LLC
- Primary Specialty
- Clinic/Center - Mental Health (Including Community Mental Health Center)
- Enumeration Date
- Oct 13, 2025
- Last Updated
- Oct 13, 2025
Practice Location
- Address
- 4012 COCKRELL LN
- City
- Springfield
- State
- Illinois
- ZIP Code
- 62711-8327
- Phone
- (847) 324-3543
Authorized Official
- Name
- SARIAH HOPKINS, CHC
- Title
- COMPLIANCE OFFICER
- Phone
- (847) 324-3543
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Adult Mental Health — Adult Mental Health |
| Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder |
| Community/Behavioral Health |
| Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center) |
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