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Ben Gordon Center
Mental Health Clinic/Center (Including Community Mental Health Center) in Malta, Illinois
NPI 1457654295

Ben Gordon Center is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Malta, IL and is specialized in Mental Health (Including Community Mental Health Center). Ben Gordon Center practices in Malta, IL. The NPI Number for Ben Gordon Center is 1457654295 and holds a License No. A0254001A (Illinois).

The current practice location address for Ben Gordon Center is 21193 Malta Rd, Malta, IL and can be reached out via phone at 815-756-4875 and via fax at 815-756-2944.

Location: 21193 Malta Rd, Malta, IL, 60150-9600
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1457654295
Provider Name
Ben Gordon Center
Credential
Provider Entity Type
Organization
Address
21193 Malta Rd, Malta, IL, 60150-9600
Phone Number
815-756-4875
Fax Number
815-756-2944
Provider Enumeration Date
12/17/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
21193 Malta Rd
City
Malta
State
Illinois
Zip
60150-9600
Phone Number
815-756-4875
Fax Number
815-756-2944
person
Provider Business Mailing Address Details
Address
21193 Malta Rd
City
Malta
State
Illinois
Zip
60150-9600
Phone Number
815-756-4875
Fax Number
815-756-2944
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
A0254001A (Illinois)
Definition
Definition to come...
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