Basic Information
| Provider Information | |||||||||
| NPI: | 1205883428 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HUMAN RESOURCES CENTER OF EDGAR AND CLARK COUNTIES | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1118 | ||||||||
| Address2: | |||||||||
| City: | PARIS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 619445118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2174654118 | ||||||||
| FaxNumber: | 2174631899 | ||||||||
| Practice Location | |||||||||
| Address1: | 745 E COURT ST | ||||||||
| Address2: | |||||||||
| City: | PARIS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 619442460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2174654118 | ||||||||
| FaxNumber: | 2174631899 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2006 | ||||||||
| LastUpdateDate: | 09/17/2021 | ||||||||
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| AuthorizedOfficialLastName: | BURNS | ||||||||
| AuthorizedOfficialFirstName: | JONATHAN | ||||||||
| AuthorizedOfficialMiddleName: | RICHARD | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2174654118 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | A-0236-0002-A | IL | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | 04072 | IL | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health | 251C00000X | 04072 | IL | N | Agencies | Day Training, Developmentally Disabled Services | 261QR0405X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
No ID Information.