Peoria Treatment Center, LLC
NPI 1073944567 · Substance Use Disorder Rehabilitation Clinic/Center · East Peoria, IL
Enrolled with Medicare as Part B Supplier - Opioid Treatment Program (otp) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1073944567
- Entity type
- Organization
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Bruce Jarvie, Vp, Treasurer(214) 379-3300
Specialties & taxonomies
Ambulatory Health Care Facilities
- Methadone Clinic261QM2800X
Ambulatory Health Care Facilities
- Community/Behavioral Health Agency251S00000X
Agencies
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Medmark Treatment Centers East Peoria
Registry dates
- Enumerated
- 2013-12-09
- Last updated
- 2026-01-13
- Certified
- 2026-01-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.