NPIMap

Organization Active NPI

Human Service Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Peoria, IL
National Provider Identifier
1144549494
Registry record updated Dec 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
HUMAN SERVICE CENTER
Practice address
3420 N Rochelle LN
Peoria, IL 61604-1035
Phone
(309) 222-2185
Fax
(309) 282-1089
NPI assigned
May 26, 2010
Last updated
Dec 14, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2017

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

Authorized official

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X A-0324-0007A IL
Methadone Clinic 261QM2800X PS0144648 NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary
Community/Behavioral Health Agency 251S00000X A0324-0007-A IL

Addresses

Primary practice location

3420 N Rochelle LN
Peoria, IL 61604-1035

Mailing address

PO Box 1346
Peoria, IL 61654-1346
Phone (309) 671-8005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Opioid treatment program
Medicare-enrolled since Mar 9, 2026

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200114000348 IL Part B Supplier - Opioid Treatment Program (Otp) 6901896968 Practice locations: Peoria, IL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

130 N Richard Pryor Pl
Peoria, IL 61605
Phone (309) 267-2289

1924 SW Adams St
Peoria, IL 61602
Phone (309) 671-8553

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

3420 N Rochelle Ln
Peoria, IL 61604
Phone (309) 222-2185

3500 W New Leaf Ln
Peoria, IL 61615
Phone (309) 671-8000

600 Fayette St
Peoria, IL 61603
Phone (309) 671-8020

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513209600000",
    "number": "1144549494",
    "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",
            "telephone_number": "309-671-8005",
            "fax_number": "309-671-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 N ROCHELLE LN",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616041035",
            "telephone_number": "309-222-2185",
            "fax_number": "309-282-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMAN SERVICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-26",
        "last_updated": "2017-12-14",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "IL",
            "license": "A-0324-0007A",
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": "PS0144648",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "A0324-0007-A",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.