Organization
CHILDREN'S HOME ASSOCIATION OF ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT GEORGE (CEO)
(309) 687-7218
Entity
Organization
Contact information
Practice address
2011 N KNOXVILLE AVE, PEORIA, IL 61603-2414
(309) 685-1047
(309) 687-7299
Mailing address
2130 N KNOXVILLE AVE, PEORIA, IL 61603-2460
(309) 685-1047
(309) 687-7299
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
004259-13
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2B05-IPI-130
—
IL
Enumeration date
07/06/2016
Last updated
07/11/2016
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