Healthcare Provider Details

I. General information

NPI: 1437328283
Provider Name (Legal Business Name): COMPREHENSIVE BEHAVIORAL HEALTH CENTER OF ST. CLAIR COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 S 8TH ST
EAST SAINT LOUIS IL
62201
US

IV. Provider business mailing address

505 S 8TH ST
EAST SAINT LOUIS IL
62201-2919
US

V. Phone/Fax

Practice location:
  • Phone: 618-482-7330
  • Fax:
Mailing address:
  • Phone: 618-482-7330
  • Fax: 618-482-4351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH J HARPER
Title or Position: EXECUTIVE DIRECTOR
Credential: LSCW, MBA, CDAC
Phone: 618-482-7330