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Organization
CARITAS
Active
Organization
CARITAS
Active
Parent organization
CARITAS
Other names
Caritas Central Intake
Organization subpart
Yes
Provider details
NPI number
Legal business name
CARITAS
Authorized official
JESSECA WATSON (CREDENTIALING MANAGER)
(630) 572-8228
Entity
Organization
Contact information
Practice address
140 NORTH ASHLAND AVENUE, CHICAGO, IL 60607
(312) 850-9411
(312) 850-3288
Mailing address
1301 WEST 22ND STREET, SUITE 500, OAK BROOK, IL 60523
(630) 572-0556
(630) 572-0566
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023
—
IL
01
—
A-0554-0001-A
ILLINOIS DEPARTMENT OF HUMAN SERVICES - SUPR
IL
Enumeration date
01/30/2007
Last updated
02/12/2021
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