Organization
CENTRAL ILLINOIS FRIENDS OF PWA, INC.
Active
Other names
Central Illinois Friends
Organization subpart
No
Provider details
NPI number
Authorized official
DERIC KIMLER (EXECUTIVE DIRECTOR)
(309) 671-2144
Entity
Organization
Contact information
Practice address
2112 E WAR MEMORIAL DR, PEORIA, IL 61614-8002
(309) 431-5880
Mailing address
PO BOX 5022, PEORIA, IL 61601-5022
(309) 671-2144
(309) 671-5108
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
363LC1500X
Community Health Nurse Practitioner
—
—
Other
Enumeration date
09/21/2020
Last updated
01/23/2026
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