Organization
SPECIALIZED ASSISTANCE SERVICES, NFP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. A. DORIS REYNOLDS JD (PRESIDENT AND CEO)
(312) 808-3218
Entity
Organization
Contact information
Practice address
333 W EVERGREEN ST, MANTENO, IL 60950-9329
(815) 468-6556
(815) 468-1098
Mailing address
2630 S WABASH AVE, CHICAGO, IL 60616-2825
(312) 808-3218
(312) 791-9037
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
A-0584-0002-A
IL
Other
Enumeration date
12/15/2016
Last updated
12/15/2016
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