CHILDREN'S HOME ASSOCIATION OF ILLINOIS NPI 1174583660

NPI Information

NPI: 1174583660
Provider Name: CHILDREN'S HOME ASSOCIATION OF ILLINOIS
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
2130 NORTH KNOXVILLE AVE
PEORIA, IL
ZIP 61603
Phone: (309) 685-1047
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CHILDREN'S HOME ASSOCIATION OF ILLINOIS is a mental health (including community mental health center) clinic center in Peoria, IL. CHILDREN'S HOME ASSOCIATION OF ILLINOIS NPI is 1174583660. The provider is registered as an organization entity type.

The provider's business location address is:

2130 NORTH KNOXVILLE AVE
PEORIA, IL
ZIP 61603
Phone: (309) 685-1047
Fax: (309) 687-7299

The provider's authorized official is Aaron Miller .
The authorized official title is Billing Analyst and has the following contact phone number (309) 687-7241.

The enumeration date for this NPI number is 3/27/2006 and was last updated on 11/6/2017.

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	251V00000X	Voluntary or Charitable		No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	Yes
3	320800000X	Community Based Residential Treatment Facility, Mental Illness		No
4	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children		No
5	251S00000X	Community/Behavioral Health		No

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
1	=========014	MEDICAID	ILLINOIS
2	=========011	MEDICAID	ILLINOIS
3	=========012	MEDICAID	ILLINOIS
4	=========001	MEDICAID	ILLINOIS
5	=========013	MEDICAID	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: 4/28/2024

NPI Synchronization or Removal

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