Organization
TWO RIVERS OUTREACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN PETER MCINTYRE CADC (BUSINESS OWNER)
(815) 220-0299
Entity
Organization
Contact information
Practice address
401 W BRIDGE ST, STREATOR, IL 61364-2705
(815) 220-0299
Mailing address
401 W BRIDGE ST, STREATOR, IL 61364-2705
(815) 220-0299
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
A85410002A
IL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/07/2017
Last updated
12/10/2020
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