Organization
TAZWOOD MENTAL HEALTH CENTER, INC.
Active
Parent organization
TAZWOOD MENTAL HEALTH CENTER, INC.
Other names
Tazwood Center for Wellness
Organization subpart
Yes
Provider details
NPI number
Legal business name
TAZWOOD MENTAL HEALTH CENTER, INC.
Authorized official
DAVID W. MINGUS MA (CEO)
(309) 477-5525
Entity
Organization
Contact information
Practice address
601 TAYLOR ST, EAST PEORIA, IL 61611
(309) 347-5522
(309) 347-4264
Mailing address
3248 VANDEVER AVE, PEKIN, IL 61554-6257
(309) 347-5522
(309) 347-4264
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
IL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
949000
—
IL
Enumeration date
06/09/2015
Last updated
07/12/2018
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