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NPI Code Detail

MEDICARE: TREATMENT ALTERNATIVES FOR SAFE COMMUNITIES

MEDICARE: TREATMENT ALTERNATIVES FOR SAFE COMMUNITIES
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
1251S00000XCommunity/Behavioral Health AgencyA-0637-0002-AIL
2261QR0405XSubstance Use Disorder Rehabilitation Clinic/CenterA-0637-0002-AIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619335098
Entity Type Code : Organization
Provider Name (Legal Business Name) : TREATMENT ALTERNATIVES FOR SAFE COMMUNITIES
Provider Business Mailing Address
First Line : 700 S CLINTON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60607-4350
Country : US
Telephone Number : 312-787-0208
Fax Number : 312-787-9663
Provider Business Practice Location Address
First Line : 1100 S HAMILTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60612-4207
Country : US
Telephone Number : 312-666-7339
Fax Number : 312-738-9260
Authorized Official
Title or Position : VICE PRESIDENT AND CFO
Name : MR. ROY FESMIRE
Credential :
Telephone Number : 312-787-0208
Provider Enumeration Date : 02/01/2016
Last Update Date : 11/29/2016

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Directions to “TREATMENT ALTERNATIVES FOR SAFE COMMUNITIES ” Practice Location

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