Organization
TAZWOOD MENTAL HEALTH CENTER, INC.
Active
Organization
TAZWOOD MENTAL HEALTH CENTER, INC.
Active
Other names
TMHC East Peoria SA
Organization subpart
No
Provider details
NPI number
Authorized official
DAVE WALTER MINGUS LCPC (CEO)
(309) 347-5579
Entity
Organization
Contact information
Practice address
111 W. WASHINGTON STREET, SUITE 230, EAST PEORIA, IL 61611
(309) 694-6462
(309) 694-7812
Mailing address
3248 VANDEVER AVE, PEKIN, IL 61554-6257
(309) 347-5522
(309) 347-4264
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
03/20/2007
Last updated
07/12/2018
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