Organization
EPIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIA KIM CORNWELL (CEO)
(309) 691-3800
Entity
Organization
Contact information
Practice address
1913 W TOWNLINE RD, PEORIA, IL 61615-1621
(309) 691-3800
(309) 689-3613
Mailing address
PO BOX 3418, 1913 TOWNLINE ROAD, PEORIA, IL 61612-3418
(309) 691-3800
(309) 689-3613
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
IL
251S00000X
Community/Behavioral Health Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
IL
Other
Enumeration date
03/06/2007
Last updated
06/01/2016
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