Organization
CARITAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSECA WATSON (CONTRACTS AND CREDENTIALING MANAGER)
(630) 572-8228
Entity
Organization
Contact information
Practice address
140 N ASHLAND AVE, CHICAGO, IL 60607-1802
(312) 850-9411
(312) 850-3288
Mailing address
1301 W 22ND ST STE 500, OAK BROOK, IL 60523-2014
(630) 572-8228
(630) 572-0566
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/06/2020
Last updated
07/06/2020
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