TAZWOOD CENTER FOR WELLNESS – NPI #1538540190
Clinic/Center

TAZWOOD CENTER FOR WELLNESS is an AHC clinic located in EAST PEORIA, IL. NPPES has assigned the NPI number 1538540190 to TAZWOOD CENTER FOR WELLNESS on June 09, 2015. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “TAZWOOD CENTER FOR WELLNESS” is a dba name, the actual legal business name for this organization is TAZWOOD MENTAL HEALTH CENTER, INC.. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QM0801X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Mental Health (Including Community Mental Health Center)

The NPI profile was previously updated about 8 years ago on Jul 12, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for TAZWOOD CENTER FOR WELLNESS below.

NPI Profile for
TAZWOOD MENTAL HEALTH CENTER, INC.

NPI Number
1538540190
Enumeration Date

(more than 11 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
TAZWOOD MENTAL HEALTH CENTER, INC.
Doing Business As (dba): TAZWOOD CENTER FOR WELLNESS
Primary location
601 TAYLOR ST
EAST PEORIA, IL 61611
Phone: (309) 347-5522 Fax: (309) 347-4264
Mailing address
3248 VANDEVER AVE
PEKIN, IL 61554-6257
Phone: (309) 347-5522 Fax: (309) 347-4264
Organization Subpart
Yes - TAZWOOD CENTER FOR WELLNESS is subpart of another organization.
Authorized Official
DAVID MINGUS
CEO
Phone: (309) 477-5525
Updated
Identifiers

Identifiers for TAZWOOD CENTER FOR WELLNESS

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDIL949000
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.