Organization
INSTITUTE FOR HUMAN RESOURCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY RAE LARKIN (BUSINESS MANAGER)
(815) 844-6109
Entity
Organization
Contact information
Practice address
920 W CUSTER AVE, PONTIAC, IL 61764-1067
(815) 844-6109
Mailing address
PO BOX 768, PONTIAC, IL 61764-0768
(815) 844-6109
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A-0239-0001-A
—
IL
Enumeration date
08/04/2008
Last updated
06/27/2024
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