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7620 N University St Ste 109 Peoria IL 61614-8300 | |
| (708) 747-2655 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7620 N University St Ste 109, Peoria, Illinois |
| Authorized Official Name and Position | Marvena Twigg (PRESIDENT/CEO) |
| Authorized Official Contact | 8882022965 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1801 Watermark Dr Ste 200 Columbus OH 43215-7088 Ph: (614) 487-8758 | 7620 N University St Ste 109 Peoria IL 61614-8300 Ph: (708) 747-2655 |
| NPI Number | 1275344939 |
|---|---|
| Provider Enumeration Date | 01/14/2025 |
| Last Update Date | 01/24/2025 |
| Certification Date | 01/24/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275344939 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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