Healthcare Provider Details

I. General information

NPI: 1346521598
Provider Name (Legal Business Name): HUMAN RESOURCES CENTER OF EDGAR AND CLARK COUNTIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 E COURT ST
PARIS IL
61944-2210
US

IV. Provider business mailing address

118 E COURT ST P.O. BOX 1118
PARIS IL
61944-2210
US

V. Phone/Fax

Practice location:
  • Phone: 217-465-4118
  • Fax: 217-463-1899
Mailing address:
  • Phone: 217-465-4118
  • Fax: 217-463-1899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateIL

VIII. Authorized Official

Name: MR. KENNETH A. POLKY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 217-465-4118