Organization
ADVANCED COUNSELING EVALUATION TREATMENT AND DUI SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ADAM BURASH CSADC (COUNSELOR)
(815) 343-5691
Entity
Organization
Contact information
Practice address
705 E LINCOLN ST, SUITE 204, NORMAL, IL 61761-6406
(309) 808-1017
Mailing address
705 E LINCOLN ST, SUITE 204, NORMAL, IL 61761-6406
(309) 808-1017
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
A75150001A
IL
Other
Enumeration date
11/01/2016
Last updated
11/01/2016
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