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General NPI Number Information
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NPI Number | 1679691323
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Entity Type | Organization
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Legal Business Name | RENZ ADDICTION COUNSELING CENTER
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 11/07/2016
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Provider Practice Location Address
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Address Line | 2 AMERICAN WAY
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City | ELGIN
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State | IL
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Zip | 60120-4341
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Country | US
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Telephone | 847-742-3545
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Fax | 847-697-5583
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Provider Business Mailing Address
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Address Line | 2 AMERICAN WAY
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City | ELGIN
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State | IL
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Zip | 60120-4341
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Country | US
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Telephone | 847-742-3545
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Fax | 847-697-5583
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Authorized Official
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Title or Position | COORD ADM SVCS
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Name | MS. LORA TOVAR
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Credential |
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Telephone | 847-742-3545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | A06090001A
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | A06090001A
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License Number State | IL
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