Springfield Treatment Center, LLC
Clinic/Center, Methadone Clinic in Springfield, IL. Organization (NPI-2).
NPI number1871132142
StatusActive
Last updated in NPPESJul 29, 2024
Details
- NPI
- 1871132142
- Entity type
- Organization (NPI-2)
- Legal business name
- Springfield Treatment Center, LLC
- Organization subpart
- No
- Enumeration date
- Jan 3, 2020
- Certification date
- Jul 29, 2024
- Last updated
- Jul 29, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM2800X | Clinic/Center, Methadone Clinic | – | – | Yes |
| 251S00000X | Community/Behavioral Health | – | – | |
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – |
Other names
- Medmark Treatment Centers Springfield (Doing Business As)
Practice location
1227 S 9th StSpringfield, IL 62703-2524
Phone 217-679-1406 · Fax 217-679-1545
Mailing address
1720 Lakepointe Dr Ste 117Lewisville, TX 75057-6425
Phone 214-379-3300
Authorized official
Bruce Jarvie
Vp, Treasurer
2143793300
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