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Organization
CENTRAL ILLINOIS FRIENDS OF PWA, INC.
Active
Organization
CENTRAL ILLINOIS FRIENDS OF PWA, INC.
Active
Other names
Central Illinois Friends
Organization subpart
No
Provider details
NPI number
Authorized official
DERIC KIMLER (EXECUTIVE DIRECTOR)
(309) 671-2144
Entity
Organization
Contact information
Practice address
2112 E WAR MEMORIAL DR, PEORIA, IL 61614-8002
(309) 431-5880
Mailing address
PO BOX 5022, PEORIA, IL 61601-5022
(309) 671-2144
(309) 671-5108
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NULL
251K00000X
Public Health or Welfare Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
251V00000X
Voluntary or Charitable Agency
—
NULL
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
363LC1500X
Community Health Nurse Practitioner
—
NULL
363LC1500X
Community Health Nurse Practitioner
—
—
Other
Enumeration date
09/21/2020
Last updated
01/23/2026
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