Central Illinois Friends Of Pwa, Inc.

LBN: Central Illinois Friends Of Pwa, Inc.
Central Illinois Friends Of Pwa, Inc. is an health care organization with primary practice located at 120 Ne Glen Oak Ave Ste 201 , Peoria IL 61603-4315. The organization recently has 5 registered licenses in different health care specialties including Agencies / Case Management, Agencies / Public Health or Welfare, Agencies / Community/Behavioral Health, Agencies / Voluntary or Charitable, Ambulatory Health Care Facilities / Clinic/Center. Agencies / Community/Behavioral Health is the primary health care specialty. Central Illinois Friends Of Pwa, Inc. can be contacted via phone (309) 671-2144, or through Kimler, Deric via phone (309) 671-2144.

Contact Information

Primary practice address
120 Ne Glen Oak Ave Ste 201 Peoria IL 61603-4315
Phone: (309) 671-2144
Fax: (309) 671-5108
Website:
Map and Directions
Authorized official contact:
Name: Kimler, Deric
Phone: (309) 671-2144

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X
Agencies / Public Health or Welfare 251K00000X
Agencies / Community/Behavioral Health 251S00000X
Agencies / Voluntary or Charitable 251V00000X
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1447866900
LBN Legal business name Central Illinois Friends Of Pwa, Inc.
DBA Doing business as
Authorized official Kimler, Deric
Entity Organization
Organization subpart 1 No
Enumeration date Sep 21st, 2020
Last updated Sep 21st, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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