The Otherside a Behavioral Healthcare Corp
NPI #1740543305 in Urbana, Illinois
Provider Information
- NPI Number
- 1740543305
- Entity Type
- Organization
- Organization Name
- The Otherside a Behavioral Healthcare Corp
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Jun 19, 2012
- Last Updated
- Jun 20, 2012
Practice Location
Authorized Official
- Name
- MR. LEONARD EUGENE DEFORGE
- Title
- OWNER/MANAGER
- Phone
- (217) 607-0098
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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