HUMAN SERVICE CENTER (NPI# 1922311679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922311679 |
| Entity Type | Organization |
| Organization Name | HUMAN SERVICE CENTER |
| Practice Address |
228 Ne Jefferson Ave Peoria IL 61603-3802 |
| Mailing Address |
Po Box 1346 600 Fayette Peoria IL 61654-1346 |
| Practice Telephone | 3096718000 |
| Practice Fax Number | 3096714695 |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | MICHAEL KENNEDY (PRESIDENT/CEO) |
| Authorized Official Telephone | 3096718005 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
04074 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 015 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5113 N Executive Dr, Peoria, IL 616144895 | 3096718000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225415136 | Human Service Center | Clinic/Center | 3500 W New Leaf Lane, Retreat Wing, Peoria, IL 61615 | 2015-04-29 |
| 1417207861 | Human Service Center | Clinic/Center | 109 West Elm Street, Okawville, IL 62271 | 2012-09-13 |
| 1952615338 | Human Service Center | Community/Behavioral Health | 600 Fayette St, Peoria, IL 61603-3610 | 2010-07-28 |
| 1841504222 | Human Service Center | Community Based Residential Treatment Facility, Mental Illness | 405 Ne Perry Ave, Peoria, IL 61603-3629 | 2010-07-28 |
| 1578876074 | Human Service Center | Community Based Residential Treatment Facility, Mental Illness | 1924 Sw Adams St, Peoria, IL 61602-1718 | 2010-07-26 |
| 1366755860 | Human Service Center | Community/Behavioral Health | 1200 Hamilton Blvd, Peoria, IL 61606-1525 | 2010-07-26 |
| 1851604359 | Human Service Center | Clinic/Center | 130 N Richard Pryor Pl, Peoria, IL 61605-2484 | 2010-07-26 |
| 1144549494 | Human Service Center | Community/Behavioral Health | 3420 N Rochelle Ln, Peoria, IL 61604-1035 | 2010-05-26 |
| 1013245448 | Human Service Center | Community/Behavioral Health | 1005 Ne Jefferson Ave, Peoria, IL 61603-4064 | 2009-11-23 |
| 1033340773 | Human Service Center | Clinic/Center | 3500 W New Leaf Ln, Peoria, IL 61615-3366 | 2009-07-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HUMAN SERVICE CENTER | 10257 State Rte 3, Red Bud, IL 62278-4418 |
| Street Address |
228 NE JEFFERSON AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-3802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326045675 | Christopher Michael Gillette | Pharmacist | 228 Ne Jefferson Ave, Peoria, IL 61603-3639 | 2005-07-01 |
| 1427603935 | Jonathan William Mooney | Nurse Practitioner | 228 Ne Jefferson Ave, Peoria, IL 61603-3802 | 2019-08-02 |
| 1215488697 | Jacqueline Jones Toal | Nurse Practitioner | 228 Ne Jefferson Ave, Peoria, IL 61603-3802 | 2016-10-20 |
| 1588013783 | Krystyn Gunther | Counselor | 228 Ne Jefferson Ave, Peoria, IL 61603-3802 | 2016-06-08 |
| 1578940557 | Human Service Center | Community/Behavioral Health | 228 Ne Jefferson Ave, Peoria, IL 61603-3802 | 2015-04-29 |
| 1679826887 | Cynthia L Gilmer | Counselor | 228 Ne Jefferson Ave, Peoria, IL 61603-3802 | 2012-10-25 |
| 1922351139 | Lyuba Z Shur | Counselor | 228 Ne Jefferson Ave, Peoria, IL 61603-3802 | 2012-10-25 |
| 1679719777 | Suparna Basu | Psychiatry & Neurology | 228 Ne Jefferson Ave, Peoria, IL 61603-3802 | 2008-12-21 |
| 1104941657 | George Kenneth Shotick Jr. | Family Medicine | 228 Ne Jefferson Ave, Peoria, IL 61603-3802 | 2007-03-20 |
| 1306880281 | Narayana Reddy | Psychiatry & Neurology | 228 Ne Jefferson Ave, Peoria, IL 61603-3802 | 2006-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689192486 | Children's Home Association of Illinois | Clinic/Center | 5401 N Knoxville Ave Ste 412a, Peoria, IL 61614-5021 | 2017-09-01 |
| 1851604359 | Human Service Center | Clinic/Center | 130 N Richard Pryor Pl, Peoria, IL 61605-2484 | 2010-07-26 |
| 1245363894 | Phoenix Christian Counseling Associates | Clinic/Center | 8419 W Wethersfield Rd, Peoria, AZ 85381-8123 | 2007-03-13 |
| 1396876140 | Counseling & Family Services | Clinic/Center | 330 Sw Washington St, Peoria, IL 61602-1417 | 2007-03-07 |
| 1235219973 | D Teichmann PC | Clinic/Center | 4715 N Laurel Dr, Peoria, IL 61614-5533 | 2006-10-17 |
| 1689299976 | Phoenix Christian Psychotherapy Services LLC | Clinic/Center | 14050 N 83rd Ave Ste 290, Peoria, AZ 85381-5650 | 2020-06-11 |
| 1760918254 | Faith Solutions To Mental Health | Clinic/Center | 14050 N 83rd Ave Ste 290, Peoria, AZ 85381-5650 | 2017-05-04 |
| 1740533900 | Children's Home Association of Illinois | Clinic/Center | 2011 N Knoxville Ave, Peoria, IL 61603-2414 | 2012-10-24 |
| 1093029308 | Human Service Center | Clinic/Center | 2101 W Willow Knolls Dr, Peoria, IL 61614-1219 | 2010-07-28 |
| 1720392038 | Human Service Center | Clinic/Center | 3500 W New Leaf Ln, Peoria, IL 61615-3366 | 2010-07-28 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.