MEDICARE: PIONEER CENTER FOR HUMAN SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1891828976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIONEER CENTER FOR HUMAN SERVICES

Provider Business Mailing Address
First Line	:	4031 W DAYTON ST
Second Line	:
City	:	MCHENRY
State	:	IL
Zip	:	60050-8377
Country	:	US
Telephone Number	:	815-344-1230
Fax Number	:	815-344-3815

Provider Business Practice Location Address
First Line	:	4001 W DAYTON ST
Second Line	:
City	:	MCHENRY
State	:	IL
Zip	:	60050-8377
Country	:	US
Telephone Number	:	815-344-1230
Fax Number	:	815-344-3815

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	MR. FRANK SAMUEL
Credential	:
Telephone Number	:	815-344-1230

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	07/26/2021

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Directions to “PIONEER CENTER FOR HUMAN SERVICES ” Practice Location

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