Organization
RICCA
Active
Other names
Rock Island County Council on Addictions
Organization subpart
No
Provider details
NPI number
Authorized official
MARY J. ENGHOLM CADC, CAMS II (EXECUTIVE DIRECTOR)
(309) 792-0292
Entity
Organization
Contact information
Practice address
1607 JOHN DEERE RD, EAST MOLINE, IL 61244-9662
(309) 792-0292
(309) 792-1121
Mailing address
1607 JOHN DEERE RD, EAST MOLINE, IL 61244-9662
(309) 792-0292
(309) 792-1121
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
A-0625-0004-A
IL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
IL
Other
Enumeration date
03/28/2007
Last updated
07/17/2017
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