| Children's Home Association Of Illinois | |
|
5401 N Knoxville Ave Ste 412a Peoria IL 61614-5021 | |
| (309) 687-7241 | |
| Not Available |
| Full Name | Children's Home Association Of Illinois |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5401 N Knoxville Ave Ste 412a, Peoria, Illinois |
| Authorized Official Name and Position | Aaron Miller (BILLING ANALYST) |
| Authorized Official Contact | 3096877241 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Home Association Of Illinois 2130 N Knoxville Ave Peoria IL 61603-2460 Ph: () - | Children's Home Association Of Illinois 5401 N Knoxville Ave Ste 412a Peoria IL 61614-5021 Ph: (309) 687-7241 |
| NPI Number | 1689192486 |
|---|---|
| Provider Enumeration Date | 09/01/2017 |
| Last Update Date | 09/01/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689192486 | NPI | - | NPPES |
| 2B05-IPI-130 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 2B05-IPI-130 (Illinois) | Primary |
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