NPIMap

Organization Active NPI

Human Support Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Waterloo, IL
National Provider Identifier
1639660244
Registry record updated May 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
A-0112-0001-A Issued in IL
Legal business name
HUMAN SUPPORT SERVICES
Practice address
988 N Illinois Route 3
Waterloo, IL 62298-1059
Phone
(618) 939-4444
Fax
(618) 939-4181
NPI assigned
May 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2018

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

Authorized official

Name
Melissa Jones
Title
Billing Manager
Phone
(618) 939-4444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X A-0112-0001-A IL Primary

Addresses

Primary practice location

988 N Illinois Route 3
Waterloo, IL 62298-1059

Mailing address

PO Box 146
Waterloo, IL 62298-0146
Phone (618) 939-4444

National Provider Directory

National Provider Directory
Tax ID family
Human Support Services18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526860800000",
    "number": "1639660244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 146",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622980146",
            "telephone_number": "618-939-4444",
            "fax_number": "618-939-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 N ILLINOIS ROUTE 3",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981059",
            "telephone_number": "618-939-4444",
            "fax_number": "618-939-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMAN SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-21",
        "last_updated": "2018-05-21",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "618-939-4444"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": "A-0112-0001-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; 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.