Illinois Medicaid-Substance Abuse Macomb
Illinois Medicaid-Substance Abuse Macomb is an Addiction (Substance Use Disorder) Counselor in Macomb, Illinois. Licensed in Illinois. Registered with an NPI since 2015.
- Licensed in
- IL
- In the registry since
- 2015
- Specialties on file
- 5
Practice location Address checks out
900 S Deer RdMacomb, IL 61455-2639
Phone: (309) 837-4876
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Substance Use Disorder Rehabilitation Clinic/Center (primary) | Taxonomy 261QR0405X (IL) |
|---|---|
| Addiction (Substance Use Disorder) Counselor | Taxonomy 101YA0400X · Licence A-0118-0010-A (IL) |
| Psychiatry Physician | Taxonomy 2084P0800X (IL) |
| Child & Adolescent Psychiatry Physician | Taxonomy 2084P0804X (IL) |
| Methadone Clinic | Taxonomy 261QM2800X |
Record details
| NPI number | 1588032460 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Bridgeway Inc |
| Authorized official | Bill Nelson — Ceo · (309) 344-4200 |
| NPI enumerated | September 9, 2015 |
| Last updated in NPPES | August 19, 2019 |
| Mailing address | 900 S Deer Rd, Macomb, IL 61455-2639 |
Other providers in Macomb
-
Amanda Michele Bolte, CADC
900 S Deer Rd, Macomb, IL 61455-2639 · (309) 837-4876
-
MS. Rosemary Irene John, CRSS, CADC
505 E Grant St, Macomb, IL 61455-3352 · (309) 836-1582
-
Kathleen Kenney, LCSW, CADC
1 University Cir, Macomb, IL 61455-1367 · (630) 483-7071