Ben Gordon Center

NPI #1457654295 in Malta, Illinois

Provider Information

NPI Number
1457654295
Entity Type
Organization
Organization Name
Ben Gordon Center
Subpart
Yes (part of a larger organization)
Parent Organization
BEN GORDON CENTER
Primary Specialty
Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date
Dec 17, 2010
Last Updated
Dec 17, 2010

Practice Location

Address
21193 MALTA RD
Address 2
BLDG. A - U154
City
Malta
ZIP Code
60150-9600
Phone
(815) 756-4875

Authorized Official

Name
MICHAEL FLORA
Title
CEO/PRESIDENT
Phone
(815) 756-4875

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Mental Health (Including Community Mental Health Center)Mental Health (Including Community Mental Health Center)

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