# CENTRAL ILLINOIS FRIENDS OF PWA, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Central Illinois Friends
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447866900
- **Authorized official:** DERIC KIMLER (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (309) 671-2144

## Contact information

- **Practice address:** 2112 E WAR MEMORIAL DR, PEORIA, IL 61614-8002
- **Practice address phone:** (309) 431-5880
- **Mailing address:** PO BOX 5022, PEORIA, IL 61601-5022
- **Mailing address phone:** (309) 671-2144
- **Mailing address fax:** (309) 671-5108

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 363LC1500X | Community Health Nurse Practitioner | — | NULL | — |
| 363LC1500X | Community Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 09/21/2020
- **Last updated:** 01/23/2026