Provider Demographics
NPI:1104565795
Name:ARMOR BEARER SERVICES INC
Entity type:Organization
Organization Name:ARMOR BEARER SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TALEATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW,LPHA
Authorized Official - Phone:217-402-4226
Mailing Address - Street 1:861 W WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62522-2351
Mailing Address - Country:US
Mailing Address - Phone:217-402-4226
Mailing Address - Fax:
Practice Address - Street 1:861 W WILLIAM ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62522-2351
Practice Address - Country:US
Practice Address - Phone:217-402-4226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARMOR BEARER SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-01
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty