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NPI Code Detail

MEDICARE: COMPREHENSIVE BEHAVIORAL HEALTH CENTER OF ST. CLAIR COUNTY, INC.

MEDICARE: COMPREHENSIVE BEHAVIORAL HEALTH CENTER OF ST. CLAIR COUNTY, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063872570
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPREHENSIVE BEHAVIORAL HEALTH CENTER OF ST. CLAIR COUNTY, INC.
Provider Business Mailing Address
First Line : 505 S 8TH ST
Second Line :
City : EAST SAINT LOUIS
State : IL
Zip : 62201-2919
Country : US
Telephone Number : 618-482-7330
Fax Number : 618-482-4351
Provider Business Practice Location Address
First Line : 505 S 8TH ST
Second Line :
City : EAST SAINT LOUIS
State : IL
Zip : 62201-2919
Country : US
Telephone Number : 618-482-7330
Fax Number : 618-482-4351
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. JOSEPH HARPER
Credential : LCSW, MBA, CADC
Telephone Number : 618-482-7330
Provider Enumeration Date : 02/25/2016
Last Update Date : 07/12/2023

Similar Medicare Providers

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1255500377 — COMPREHENSIVE BEHAVIORAL HEALTH CENTER OF ST. CLAIR COUNTY, INC.
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1598996324 — MRS. SANDRA M COLLIER MSW, LCSW
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1457013765 — COMPREHENSIVE BEHAVIORAL HEALTH CENTER OF ST. CLAIR COUNTY, INC.
Practice Location Address:
505 S 8TH ST
EAST SAINT LOUIS, IL
62201-2919
Practice Phone: 618-482-7330
Practice Fax: 618-274-6437

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