Tazwood Center for Human Services

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

TAZWOOD CENTER FOR HUMAN SERVICES

Practice address

3248 Vandever Ave
Pekin, IL 61554

Phone

(309) 347-5522

Fax

(309) 347-4264

NPI assigned

May 18, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Michael Polson, BA

Title

Ceo

Phone

(309) 477-5555

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013960293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3248 VANDEVER AVE",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "61554",
            "telephone_number": "309-347-5522",
            "fax_number": "309-347-4264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3248 VANDEVER AVE",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "61554",
            "telephone_number": "309-347-5522",
            "fax_number": "309-347-4264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAZWOOD CENTER FOR HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POLSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-477-5555",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Briann Tate, M.D.
• Brandon C Taylor, CRNA
• Maci Marie Taylor, DPT
• Ronda Gail Taylor, RSA DSP CNA
• Tazewell Mason Cntys SP Ed
• Tazwood Mental Health Center
• Tazwood Mental Health Center, Inc.
• Tazwood Mental Health Center, Inc.
• Tazwood Mental Health Center, Inc.
• Tazwood Mental Health Center, Inc.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Pekin, IL
• Providers in Pekin, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.