TAZWOOD MENTAL HEALTH CENTER, INC. (NPI# 1629444070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629444070 |
| Entity Type | Organization |
| Organization Name | TAZWOOD MENTAL HEALTH CENTER, INC. |
| Other Organization Name | TAZWOOD CENTER FOR WELLNESS |
| Practice Address |
210 W. Walnut Street Canton IL 61520-2444 |
| Mailing Address |
210 W Walnut St Canton IL 61520-2444 |
| Practice Telephone | 3096475240 |
| Mailing Telephone | 3096475240 |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |
| Authorized Official Name | N BRENDA FRANKLIN (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 3094775526 |
| Is Organization Subpart | Y |
| Parent Organization Name | TAZWOOD MENTAL HEALTH CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 04132 | IL | Agencies |
| Other Name | Type Code |
|---|---|
| Tazwood Center for Wellness | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134464316 | Tazwood Mental Health Center, Inc. | Community/Behavioral Health | 101 S. Major Street, Eureka, IL 61530 | 2012-11-29 |
| 1053633263 | Tazwood Mental Health Center, Inc. | Community/Behavioral Health | 124-126 S. Chicago Street, Lincoln, IL 62656 | 2010-02-16 |
| 1013186683 | Tazwood Mental Health Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1421 Valle Vista Blvd, Pekin, IL 61554 | 2008-02-27 |
| 1568631133 | Tazwood Mental Health Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1425 Valle Vista Blvd, Pekin, IL 61554 | 2008-02-27 |
| 1356466007 | Tazwood Mental Health Center, Inc. | Counselor | 111 W. Washington Street, Suite 230, East Peoria, IL 61611 | 2007-03-20 |
| 1760958797 | Tazwood Mental Health Center, Inc. | Clinic/Center | 124 S Chicago St, Lincoln, IL 62656-2719 | 2018-10-17 |
| 1538540190 | Tazwood Mental Health Center, Inc. | Community/Behavioral Health | 601 Taylor St, East Peoria, IL 61611 | 2015-06-09 |
| 1629247366 | Tazwood Mental Health Center, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1423 Valle Vista Blvd, Pekin, IL 61554 | 2008-02-27 |
| 1851417091 | Tazwood Mental Health Center, Inc. | Counselor | 3248 Vandever Ave, Pekin, IL 61554-6257 | 2007-03-21 |
| 1760508907 | Tazwood Mental Health Center, Inc. | Counselor | 111 W. Washington Street, Suite 230, East Peoria, IL 61611 | 2007-03-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | TAZWOOD MENTAL HEALTH CENTER, INC. | 3248 Vandever Ave, Pekin, IL 61554-6257 |
| Street Address |
210 W. WALNUT STREET |
| City | CANTON |
| State | IL |
| Zip Code | 61520-2444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497978480 | Walton Cs-xi P.C. | Chiropractor | 410 E. Elm Street, Canton, IL 61520 | 2007-04-10 |
| 1811912918 | Jennifer Christine Daniel-price | Chiropractor | 410 E Elm Street, Canton, IL 61520 | 2006-07-12 |
| 1245216241 | Fulton County Health Department | Clinic/Center | 700 East Oak Street, Canton, IL 61520 | 2005-12-21 |
| 1124482252 | Ryan Deushane | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520 | 2016-04-05 |
| 1750749826 | Shawn Michael Wynn | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520 | 2016-02-04 |
| 1417312232 | Danielle Marianna Sausaman | Dietitian, Registered | 210 W Walnut St, Graham Hospital Food and Nutrition Services, Canton, IL 61520 | 2015-12-21 |
| 1740533835 | Abby L. Sherwood | Chiropractor | 410 E Elm Street, Canton, IL 61520 | 2012-10-26 |
| 1417261041 | Erin Kathleen Buckley | Obstetrics & Gynecology | 180 S Main St, Canton, IL 61520 | 2010-08-06 |
| 1619375532 | Brittany Nicole Miller | Nurse Practitioner | 1300 E Locust St, Canton, IL 61520-0008 | 2014-12-09 |
| 1437197845 | Heartland of Canton Il LLC | Clinic/Center | 2081 N Main St, Canton, IL 61520-1032 | 2006-06-04 |
| Find all providers in zip 61520 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457864 | Initial Steps Behavioral and Learning Services | Community/Behavioral Health | 50203 Paine St, Canton, MI 48188-3332 | 2020-11-03 |
| 1891393328 | Hws Best Health LLC | Community/Behavioral Health | 3878 Old Hickory Ave Nw, Canton, OH 44718-3871 | 2020-10-16 |
| 1427675834 | Aba Helps | Community/Behavioral Health | 5 Stratford Rd, Canton, MA 02021-4213 | 2020-07-01 |
| 1487149662 | James Lee Hicks Jr. | Community/Behavioral Health | 4826 Cranberry Ave Nw, Canton, OH 44709-1317 | 2018-06-29 |
| 1023501467 | Wendy E Hixenbaugh | Community/Behavioral Health | 400 Tuscarawas St W # Stwe200, Canton, OH 44702-2044 | 2018-06-11 |
| 1811484884 | Lifespan Incorporated | Community/Behavioral Health | 264 Lillie Ln, Canton, NC 28716-7900 | 2018-04-16 |
| 1770035487 | A B A Let's Play, Inc. | Community/Behavioral Health | 6304 Shipslanding Ave Nw, Canton, OH 44718 | 2016-10-28 |
| 1194276592 | Obtain The Promise LLC | Community/Behavioral Health | 189 Mill Creek Dr, Canton, GA 30115-6037 | 2016-10-20 |
| 1265985568 | Meah Counseling, LLC | Community/Behavioral Health | 5958 Canton Center Rd., Suite 900, Canton, MI 48187 | 2016-08-03 |
| 1245698356 | Meridian Behavioral Health Services | Community/Behavioral Health | 60 Thompson St, Canton, NC 28716-3325 | 2016-02-03 |
| Find all providers in CANTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.