MEDICARE: SOFT LANDING INTERVENTIONS, LLC

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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	261QM2800X	Methadone Clinic

General Provider Information

NPI Number	:	1457892432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOFT LANDING INTERVENTIONS, LLC

Provider Business Mailing Address
First Line	:	1240 E DIEHL RD STE 550
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60563-8206
Country	:	US
Telephone Number	:	888-782-6966
Fax Number	:	630-870-1284

Provider Business Practice Location Address
First Line	:	3934 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-2432
Country	:	US
Telephone Number	:	630-261-9220
Fax Number	:	630-689-1786

Authorized Official
Title or Position	:	DIRECTOR OF PAYER RELATIONS
Name	:	GARRY SCHECHNER
Credential	:
Telephone Number	:	407-721-1235

Provider Enumeration Date	:	03/10/2017
Last Update Date	:	03/30/2023

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