Dasa Medicaid Provider

LBN: Ben Gordon Center
Dasa Medicaid Provider is an health care organization with primary practice located at 12 Health Services Dr , Dekalb IL 60115-9637. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Ben Gordon Center can be contacted via phone (815) 756-4875, or through Flora, Michael via phone (815) 756-4875.

Contact Information

Primary practice address
12 Health Services Dr Dekalb IL 60115-9637
Phone: (815) 756-4875
Fax: (815) 756-2944
Website:
Map and Directions
Authorized official contact:
Name: Flora, Michael
Phone: (815) 756-4875

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X A0254001A Illinois

Profile Details

NPI number 1922277631
LBN Legal business name Ben Gordon Center
DBA Doing business as Dasa Medicaid Provider
Authorized official Flora, Michael
Entity Organization
Organization subpart 1 Yes
Enumeration date Feb 27th, 2008
Last updated Apr 20th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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