Organization
BLOOMINGTON-NORMAL TREATMENT CENTER, LLC
Active
Other names
MedMark Treatment Centers Normal
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE JARVIE (VP, TREASURER)
(214) 379-3300
Entity
Organization
Contact information
Practice address
303 LANDMARK DR STE 2B, NORMAL, IL 61761-6164
(309) 808-2388
Mailing address
303 LANDMARK DR, SUITE 2B, NORMAL, IL 61761-2153
(309) 808-2388
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
IL
261QM2800X
Methadone Clinic
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
09/25/2012
Last updated
07/29/2024
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