Organization · Type 2 NPI

Youth Service Bureau of Illinios Valley

Mental Health Clinic/Center (Including Community Mental Health Center) · Peru, IL

NPI number 1124748546 Active

Practice location

4231 Progress Blvd Ste 1
Peru, IL 61354-1193

Call (815) 433-3953 Map

Fax (815) 433-3980

Mailing address

424 W Madison St
Ottawa, IL 61350-2833

Specialties and licenses

Taxonomy	Code	License
Community/Behavioral Health Agency	251S00000X	None listed
Mental Health Clinic/Center (Including Community Mental Health Center) Primary	261QM0801X	None listed

Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...

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NPI record

NPI: 1124748546
Entity type: Organization (Type 2)
Issued: Aug 29, 2022
Last updated: Sep 20, 2022
Status: Active
Subpart: Yes of Youth Service Bureau of Illinios Valley

Other names

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Youth Service Bureau of Illinois Valley · doing business as
Youth Service Bureau of Illinois Valley · doing business as

Authorized official

Stephanie Rosales
Clinical Adm Asst
(815) 433-3953

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1124748546

Youth Service Bureau of Illinios Valley's National Provider Identifier is 1124748546, issued on Aug 29, 2022. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Peru, IL. The record was last updated on Sep 20, 2022.