NPIMap

Organization Active NPI

Tazwood Mental Health Center, Inc.

Doing business as Tazwood Center for Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lincoln, IL
National Provider Identifier
1760958797
Registry record updated Oct 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
TAZWOOD MENTAL HEALTH CENTER, INC.
Doing business as
Tazwood Center for Wellness
Practice address
124 S Chicago St
Lincoln, IL 62656-2719
Phone
(217) 732-6865
NPI assigned
Oct 17, 2018
Last updated
Oct 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2018

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

Authorized official

Name
David Mingus, LCPC, CRADCNPI 1629320676
Title
Ceo
Phone
(309) 347-5579

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

124 S Chicago St
Lincoln, IL 62656-2719

Mailing address

3248 Vandever Ave
Pekin, IL 61554-6257
Phone (309) 477-5552

Other names 1

  • Tazwood Center for Wellness Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tazwood Mental Health C14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

124 S Chicago St
Lincoln, IL 62656
Phone (217) 732-6865

Practitioners & affiliated clinicians

Practitioners 3

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": "1539734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539734400000",
    "number": "1760958797",
    "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": "615546257",
            "telephone_number": "309-477-5552",
            "fax_number": "309-347-4264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 S CHICAGO ST",
            "city": "LINCOLN",
            "state": "IL",
            "postal_code": "626562719",
            "telephone_number": "217-732-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAZWOOD MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-17",
        "last_updated": "2018-10-17",
        "status": "A",
        "authorized_official_last_name": "MINGUS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-347-5579",
        "authorized_official_credential": "LCPC, CRADC"
    },
    "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": [
        {
            "organization_name": "Tazwood Center for Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.