Healthcare Provider Details

I. General information

NPI: 1609214089
Provider Name (Legal Business Name): SOFT LANDING INTERVENTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2013
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 MARKET ST SUITE 300
DES PLAINES IL
60016-4643
US

IV. Provider business mailing address

1240 E DIEHL RD STE 550
NAPERVILLE IL
60563-8206
US

V. Phone/Fax

Practice location:
  • Phone: 630-261-9220
  • Fax:
Mailing address:
  • Phone: 888-782-6966
  • Fax: 630-870-1284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License NumberA-5218-0003-A
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: GARRY SCHECHNER
Title or Position: DIRECTOR OF PAYER RELATIONS
Credential:
Phone: 407-721-1235