Human Service Center | |
3400 W New Leaf Ln Peoria IL 61615-3311 | |
(309) 671-8005 | |
Not Available |
Full Name | Human Service Center |
---|---|
Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
Location | 3400 W New Leaf Ln, Peoria, Illinois |
Authorized Official Name and Position | Michael Kennedy (PRESIDENT/CEO) |
Authorized Official Contact | 3096718005 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Human Service Center Po Box 1346 Peoria IL 61654-1346 Ph: () - | Human Service Center 3400 W New Leaf Ln Peoria IL 61615-3311 Ph: (309) 671-8005 |
NPI Number | 1134506041 |
---|---|
Provider Enumeration Date | 04/29/2015 |
Last Update Date | 12/12/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134506041 | NPI | - | NPPES |
003240006 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 003240006 (Illinois) | Secondary |
261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | A-0324-0006-A (Illinois) | Primary |
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