Organization
ALCOHOL & DRUG EDUCATION CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MICHAEL WALSH LCPC, CADC (PRESIDENT)
(309) 794-1097
Entity
Organization
Contact information
Practice address
2052 3RD AVE, ROCK ISLAND, IL 61201-8803
(309) 794-1097
Mailing address
2052 3RD AVE, ROCK ISLAND, IL 61201-8803
(309) 794-1097
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A330800003A
IL
Other
Enumeration date
07/27/2014
Last updated
07/27/2014
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