# TRI-COUNTY ALCOHOL AND DRUG SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TRI-COUNTY ALCOHOL AND DRUG SERVICES LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1356640346
- **Legal business name:** TRI-COUNTY ALCOHOL AND DRUG SERVICES LLC
- **Authorized official:** MR. JEFFREY A EDWARDS MDIV, CADC (MANAGER/COUNSELOR)
- **Authorized official phone:** (309) 752-9740

## Contact information

- **Practice address:** 926 15TH AVE, EAST MOLINE, IL 61244-2138
- **Practice address phone:** (309) 752-9740
- **Practice address fax:** (309) 752-9744
- **Mailing address:** 926 15TH AVE, EAST MOLINE, IL 61244-2138
- **Mailing address phone:** (309) 752-9740
- **Mailing address fax:** (309) 752-9744

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | A-8601-0002-A | IL | Yes |

## Other

- **Enumeration date:** 03/16/2011
- **Last updated:** 03/16/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2575259 | CIGNA BEHAVIORAL HEALTH | IL |
| 01 | — | 9510564 | MULTIPLAN | IL |