Organization
CENTRAL ILLINOIS AGENCY ON AGING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH A RIDER (PRESIDENT/CEO)
(309) 674-2071
Entity
Organization
Contact information
Practice address
700 HAMILTON BLVD, PEORIA, IL 61603
(309) 550-5811
Mailing address
700 HAMILTON BLVD, PEORIA, IL 61603-3617
(309) 674-2071
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
U120604616
IL
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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