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Illinois Medicaid-substance Abuse Galesburg
Substance Use Disorder Rehabilitation Clinic/Center in Galesburg, Illinois
NPI 1497123509

Illinois Medicaid-substance Abuse Galesburg is a Substance Use Disorder Rehabilitation Clinic/Center based in Galesburg, IL and is specialized in Rehabilitation, Substance Use Disorder. Illinois Medicaid-substance Abuse Galesburg practices in Galesburg, IL. The NPI Number for Illinois Medicaid-substance Abuse Galesburg is 1497123509 and holds a License No. A-0118-0005-A (Illinois).

The current practice location address for Illinois Medicaid-substance Abuse Galesburg is 2323 Windish Dr, Galesburg, IL and can be reached out via phone at 309-344-4200 and via fax at 309-344-4281.

Location: 2323 Windish Dr, Galesburg, IL, 61401-9780
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1497123509
Provider Name
Illinois Medicaid-substance Abuse Galesburg
Credential
Provider Entity Type
Organization
Address
2323 Windish Dr, Galesburg, IL, 61401-9780
Phone Number
309-344-4200
Fax Number
309-344-4281
Provider Enumeration Date
09/04/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2323 Windish Dr
City
Galesburg
State
Illinois
Zip
61401-9780
Phone Number
309-344-4200
Fax Number
309-344-4281
person
Provider Business Mailing Address Details
Address
2323 Windish Dr
City
Galesburg
State
Illinois
Zip
61401-9780
Phone Number
309-344-4200
Fax Number
309-344-4281
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
(Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Methadone
Taxonomy
261QM2800X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rehabilitation, Substance Use Disorder
Taxonomy
261QR0405X
License No.
A-0118-0005-A (Illinois)
Definition
Definition to come...
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