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Organization
TRI-COUNTY ALCOHOL AND DRUG SERVICES LLC
Active
Organization
TRI-COUNTY ALCOHOL AND DRUG SERVICES LLC
Active
Parent organization
TRI-COUNTY ALCOHOL AND DRUG SERVICES LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRI-COUNTY ALCOHOL AND DRUG SERVICES LLC
Authorized official
MR. JEFFREY A EDWARDS MDIV, CADC (MANAGER/COUNSELOR)
(309) 752-9740
Entity
Organization
Contact information
Practice address
926 15TH AVE, EAST MOLINE, IL 61244-2138
(309) 752-9740
(309) 752-9744
Mailing address
926 15TH AVE, EAST MOLINE, IL 61244-2138
(309) 752-9740
(309) 752-9744
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A-8601-0002-A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2575259
CIGNA BEHAVIORAL HEALTH
IL
01
—
9510564
MULTIPLAN
IL
Enumeration date
03/16/2011
Last updated
03/16/2011
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