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General NPI Number Information
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NPI Number | 1003385881
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Entity Type | Organization
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Legal Business Name | HUMAN SERVICE CENTER
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Dates
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Enumeration Date | 11/21/2018
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 2101 W WILLOW KNOLLS DR
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City | PEORIA
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State | IL
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Zip | 61614-1219
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Country | US
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Telephone | 309-689-3074
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Fax |
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Provider Business Mailing Address
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Address Line | 600 FAYETTE ST
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City | PEORIA
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State | IL
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Zip | 61603-3610
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Country | US
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Telephone | 309-671-8005
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR OF FINANCE
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Name | ANN CAMPEN
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Credential |
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Telephone | 309-671-8025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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