Tazwood Mental Health Center, Inc.

NPI 1083671127 - Clinic/Center - 261QM0801X

NPI Details
NPI 1083671127
Enumeration Date 05/01/2006
Last Updated 12/10/2012
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name DAVE WALTER DAVE
Position CEO
Phone (309) 347-5522
Fax (309) 347-4264
Practice Location
3248 VANDEVER AVE
PEKIN IL, 61554, US
Phone (309) 347-5522
Fax (309) 347-4264
Business Location
3248 VANDEVER AVE
PEKIN IL, 61554, US
Phone (309) 347-5522
Fax (309) 347-4264
Toxanomy
Taxonomy Code 261QM0801X
License State Illinois
License Number 04132
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According to our database, Tazwood Mental Health Center, Inc. NPI is 1083671127, taxonomy code is 261QM0801X and license number is 04132, license state is located at Illinois. Tazwood Mental Health Center, Inc. physically located at 3248 Vandever Ave, Pekin IL, 61554. NPI Number 1033115704 has the healthcare provider type.

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1083671127 NPI number is provided on an as is basis without warranty of any kind. 1083671127 is maintained by the National Plan & Provider Enumeration System. The contents of Tazwood Mental Health Center, Inc. are for informational purposes only.