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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