| Human Service Center | |
|
5113 N Executive Dr Peoria IL 61614-4895 | |
| (309) 671-8000 | |
| Not Available |
| Full Name | Human Service Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5113 N Executive Dr, Peoria, Illinois |
| Authorized Official Name and Position | Fred Nirde (PRESIDENT/CEO) |
| Authorized Official Contact | 3096718005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Human Service Center Po Box 1346 600 Fayette Peoria IL 61654-1346 Ph: () - | Human Service Center 5113 N Executive Dr Peoria IL 61614-4895 Ph: (309) 671-8000 |
| NPI Number | 1558675868 |
|---|---|
| Provider Enumeration Date | 07/28/2010 |
| Last Update Date | 07/28/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558675868 | NPI | - | NPPES |
| 31 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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