County of Henry

NPI #1811730492 in Kewanee, Illinois

Provider Information

NPI Number: 1811730492
Entity Type: Organization
Organization Name: County of Henry
Primary Specialty: Clinic/Center - Adolescent and Children Mental Health
Enumeration Date: Jun 13, 2024
Last Updated: Jun 25, 2024

Practice Location

Address: 110 N BURR BLVD
City: Kewanee
State: Illinois
ZIP Code: 61443-2214
Phone: (309) 852-5272

Authorized Official

Name: TARA LAFOLLETTE
Title: CREDENTIALING REPRESENTATIVE
Phone: (309) 852-0197

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X	Primary

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