Basic Information
| Provider Information | |||||||||
| NPI: | 1063996973 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RURAL HEALTH, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 513 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ANNA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 629061668 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6188334471 | ||||||||
| FaxNumber: | 6188334900 | ||||||||
| Practice Location | |||||||||
| Address1: | 513 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ANNA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 629061668 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6188334471 | ||||||||
| FaxNumber: | 6188334900 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2018 | ||||||||
| LastUpdateDate: | 09/18/2018 | ||||||||
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| AuthorizedOfficialLastName: | FLAMM | ||||||||
| AuthorizedOfficialFirstName: | CINDY | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6188334471 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | N | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) | 171M00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.