NPIMap

Organization Active NPI

Human Service Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Peoria, IL
National Provider Identifier
1134506041
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
A-0324-0006-A Issued in IL
Legal business name
HUMAN SERVICE CENTER
Practice address
3400 W New Leaf LN
Peoria, IL 61615-3311
Phone
(309) 671-8005
NPI assigned
Apr 29, 2015
Last updated
Dec 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

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

Authorized official

Name
Michael Kennedy
Title
President/Ceo
Phone
(309) 671-8005

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X A-0324-0006-A IL Primary
Community/Behavioral Health Agency 251S00000X 003240006 IL

Addresses

Primary practice location

3400 W New Leaf LN
Peoria, IL 61615-3311

Mailing address

PO Box 1346
Peoria, IL 61654-1346

Other identifiers 1

IdentifierTypeStateIssuer
003240006MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Human Service Center26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

3400 W New Leaf Ln
Peoria, IL 61615
Phone (309) 589-1011

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513036800000",
    "number": "1134506041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1346",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616541346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W NEW LEAF LN",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616153311",
            "telephone_number": "309-671-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMAN SERVICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-29",
        "last_updated": "2017-12-12",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "309-671-8005"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": "A-0324-0006-A",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "003240006",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003240006",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; 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.