NPIMap

Organization Active NPI

Human Service Center

  • Mental Illness Community Based Residential Treatment Facility
  • Peoria, IL
National Provider Identifier
1841504222
Registry record updated Jul 28, 2010
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Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
HUMAN SERVICE CENTER
Practice address
405 NE Perry Ave
Peoria, IL 61603-3629
Phone
(309) 671-8005
NPI assigned
Jul 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Authorized official

Name
Fred Nirde
Title
President/Ceo
Phone
(309) 671-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

405 NE Perry Ave
Peoria, IL 61603-3629

Mailing address

PO Box 1346
600 Fayette
Peoria, IL 61654-1346

Other identifiers 1

IdentifierTypeStateIssuer
041MedicaidIL

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

405 NE Perry Ave
Peoria, IL 61603

NPI Registry JSON

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280275200000",
    "number": "1841504222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1346",
            "address_2": "600 FAYETTE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616541346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 NE PERRY AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033629",
            "telephone_number": "309-671-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMAN SERVICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-28",
        "last_updated": "2010-07-28",
        "status": "A",
        "authorized_official_last_name": "NIRDE",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "309-671-8000"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041",
            "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 Jul 28, 2010; 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.