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General NPI Number Information
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NPI Number | 1710344338
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Entity Type | Organization
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Legal Business Name | SPECIALIZED ASSISTANCE SERVICES, NFP
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Dates
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Enumeration Date | 01/27/2016
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Last Update Date | 08/10/2018
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Provider Practice Location Address
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Address Line | 333 W EVERGREEN ST
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City | MANTENO
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State | IL
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Zip | 60950
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Country | US
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Telephone | 312-808-3218
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Fax | 312-791-9037
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Provider Business Mailing Address
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Address Line | 2630 S WABASH AVE
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City | CHICAGO
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State | IL
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Zip | 60616-2825
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Country | US
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Telephone | 312-808-3218
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Fax | 312-791-9037
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Authorized Official
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Title or Position | VP FINANCE & ADMINISTRATION
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Name | BELINDA MORENO
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Credential |
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Telephone | 312-808-3218
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | A-0584-0004-A
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | A-0584-0002-A
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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