Organization
HUMAN SERVICE CENTER
Active
Organization
HUMAN SERVICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL KENNEDY (PRESIDENT/CEO)
(309) 671-8005
Entity
Organization
Contact information
Practice address
3420 N ROCHELLE LN, PEORIA, IL 61604-1035
(309) 222-2185
(309) 282-1089
Mailing address
PO BOX 1346, PEORIA, IL 61654-1346
(309) 671-8005
(309) 671-8021
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
A0324-0007-A
IL
261QM2800X
Methadone Clinic
A-0324-0007A
IL
261QM2800X
Methadone Clinic
PS0144648
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
05/26/2010
Last updated
12/14/2017
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