Organization
HUMAN SERVICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KENNEDY (PRESIDENT/CEO)
(309) 671-8005
Entity
Organization
Contact information
Practice address
2101 W WILLOW KNOLLS DR, PEORIA, IL 61614-1219
(309) 671-8000
Mailing address
PO BOX 1346, 600 FAYETTE, PEORIA, IL 61654
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035
—
IL
Enumeration date
07/28/2010
Last updated
12/12/2017
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