Organization
HUMAN SERVICE CENTER
Active
Organization
HUMAN SERVICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHAEL KENNEDY (PRESIDENT/CEO)
(309) 671-8089
Entity
Organization
Contact information
Practice address
2101 W WILLOW KNOLLS DR, PEORIA, IL 61614-1219
(309) 689-3074
(309) 689-3069
Mailing address
PO BOX 1346, PEORIA, IL 61654-1346
(309) 671-8005
(309) 671-8021
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
A-0324-0003-A
IL
324500000X
Substance Abuse Rehabilitation Facility
Primary
A03240003A
IL
Other
Enumeration date
07/29/2009
Last updated
12/12/2017
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