Crusaders Central Clinic Association
NPI #1346762390 in South Beloit, Illinois
Provider Information
- NPI Number
- 1346762390
- Entity Type
- Organization
- Organization Name
- Crusaders Central Clinic Association
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- CRUSADERS CENTRAL CLINIC ASSOCIATION
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Jul 12, 2017
- Last Updated
- Aug 24, 2022
Practice Location
- Address
- 840 BLACKHAWK BLVD
- City
- South Beloit
- State
- Illinois
- ZIP Code
- 61080-2263
- Phone
- (815) 490-1600
Authorized Official
- Name
- SAMUEL MILLER
- Title
- PRESDIENT & CEO
- Phone
- (815) 490-1737
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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