Organization · Type 2 NPI
Southern Illinois Treatment Center, LLC
Substance Use Disorder Rehabilitation Clinic/Center · Wood River, IL
NPI number
1841858404
Active
Practice location
304 Wesley Dr Ste 302306
Wood River, IL 62095-2266
Mailing address
1720 Lakepointe Dr Ste 117
Lewisville, TX 75057-6425
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | None listed |
| Methadone Clinic | 261QM2800X | None listed |
| Substance Use Disorder Rehabilitation Clinic/Center Primary | 261QR0405X | None listed |
Substance Use Disorder Rehabilitation Clinic/Center: Definition to come...
About NPI 1841858404
Southern Illinois Treatment Center, LLC's National Provider Identifier is 1841858404, issued on May 30, 2019. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in Wood River, IL. The record was last updated on Jul 29, 2024.