Provider Demographics
NPI:1871131953
Name:TAZEWELL COUNTY RESOURCE CENTERS INC
Entity type:Organization
Organization Name:TAZEWELL COUNTY RESOURCE CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:DURDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-347-7148
Mailing Address - Street 1:501 E HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:IL
Mailing Address - Zip Code:61550-9501
Mailing Address - Country:US
Mailing Address - Phone:309-291-0108
Mailing Address - Fax:309-291-0116
Practice Address - Street 1:501 E HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:IL
Practice Address - Zip Code:61550-9501
Practice Address - Country:US
Practice Address - Phone:309-291-0108
Practice Address - Fax:309-291-0116
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAZEWELL COUNTY RESOURCE CENTERS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-19
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health