TAZWOOD MENTAL HEALTH CENTER INC. NPI 1851417091

NPI Information

NPI: 1851417091
Provider Name: TAZWOOD MENTAL HEALTH CENTER, INC.

Other Name: TMHC PEKIN MH

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
3248 VANDEVER AVE
PEKIN, IL
ZIP 61554
Phone: (309) 347-5522
Get Directions

TAZWOOD MENTAL HEALTH CENTER, INC. is a mental health (including community mental health center) clinic center in Pekin, IL. TAZWOOD MENTAL HEALTH CENTER, INC. NPI is 1851417091. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Other Name Is Tmhc Pekin Mh.

The provider's business location address is:

3248 VANDEVER AVE
PEKIN, IL
ZIP 61554-257
Phone: (309) 347-5522
Fax: (309) 347-4264

The provider's authorized official is Dave Walter Mingus .
The authorized official title is Ceo and has the following contact phone number (309) 347-5579.

The enumeration date for this NPI number is 3/21/2007 and was last updated on 1/12/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101Y00000X	Counselor		No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
3	101YM0800X	Counselor	Mental Health	No
4	101YP2500X	Counselor	Professional	No
5	104100000X	Social Worker		No
6	1041C0700X	Social Worker	Clinical	No
7	163W00000X	Registered Nurse		No
8	171M00000X	Case Manager/Care Coordinator		No
9	2084P0800X	Psychiatry & Neurology	Psychiatry	No
10	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========006	MEDICAID	ILLINOIS
2	949000	MEDICARE UPIN	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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