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General NPI Number Information
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NPI Number | 1578332177
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Entity Type | Organization
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Legal Business Name | HUMA HEALTH
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Dates
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Enumeration Date | 12/22/2023
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 606 N GALENA AVE
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City | DIXON
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State | IL
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Zip | 61021-1620
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Country | US
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Telephone | 310-954-7940
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Fax |
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Provider Business Mailing Address
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Address Line | 606 N GALENA AVE
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City | DIXON
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State | IL
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Zip | 61021-1620
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Country | US
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Telephone | 310-954-7940
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | HUMA PEKCAN
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Credential |
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Telephone | 310-954-7940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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