MEDICARE: ALCOHOL & ADDICTIONS RESOURCE CENTER

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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1396956124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALCOHOL & ADDICTIONS RESOURCE CENTER

Provider Business Mailing Address
First Line	:	818 E JEFFERSON BLVD
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46617-2905
Country	:	US
Telephone Number	:	574-234-6024
Fax Number	:	574-234-6025

Provider Business Practice Location Address
First Line	:	818 E JEFFERSON BLVD
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46617-2905
Country	:	US
Telephone Number	:	574-234-6024
Fax Number	:	574-234-6025

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. SHARON MARIE BURDEN
Credential	:	SAP, CEAP
Telephone Number	:	574-234-6024

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	08/22/2020

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