NPI 1326279068

Human Service Center

Organisation Substance Abuse Rehabilitation Facility Peoria, IL

Practice location

Address: 2101 W Willow Knolls Dr, Peoria, IL 61614-1219
Phone: (309) 689-3074
Fax: (309) 689-3069
Mailing address: PO Box 1346, Peoria, IL 61654-1346

Authorised official

Name: Michael Kennedy
Title: President/Ceo
Phone: (309) 671-8089

Registered specialties (2)

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X Licence A03240003A (IL)

Other Substance Abuse Rehabilitation Facility providers in Illinois →

Substance Use Disorder Rehabilitation Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QR0405X Licence A-0324-0003-A (IL)

Other Clinic/Center providers in Illinois →

Registry record

NPI: 1326279068
Entity type: Organization
NPI issued: 29 Jul 2009
Record last updated: 12 Dec 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.