BLOOMINGTON-NORMAL TREATMENT CENTER LLC NPI 1225389638

NPI Information

NPI: 1225389638
Provider Name: BLOOMINGTON-NORMAL TREATMENT CENTER, LLC

Doing Business As: MEDMARK TREATMENT CENTERS NORMAL

Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

Address:
303 LANDMARK DR STE 2B
NORMAL, IL
ZIP 61761
Phone: (309) 808-2388
Get Directions

BLOOMINGTON-NORMAL TREATMENT CENTER, LLC is a methadone clinic center in Normal, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. BLOOMINGTON-NORMAL TREATMENT CENTER, LLC NPI is 1225389638. The provider is registered as an organization entity type.
The provider Is Doing Business As Medmark Treatment Centers Normal.

The provider's business location address is:

303 LANDMARK DR STE 2B
NORMAL, IL
ZIP 61761-164
Phone: (309) 808-2388

The provider's authorized official is Michael Saul .
The authorized official title is Vp and has the following contact phone number (214) 379-3300.

The CLIA number assigned to this NPI record is 14D2254654 - other - narcotic trmt program with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/25/2012 and was last updated on 2/13/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	251S00000X	Community/Behavioral Health		ILLINOIS	No
2	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder		No
3	261QM2800X	Clinic/Center	Methadone		Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »