Provider Demographics
NPI:1255483533
Name:CARE ADDICTION TREATMENT PROGRAM
Entity Type:Organization
Organization Name:CARE ADDICTION TREATMENT PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-883-3906
Mailing Address - Street 1:309 HAMILTON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2181
Mailing Address - Country:US
Mailing Address - Phone:630-402-0144
Mailing Address - Fax:773-442-0421
Practice Address - Street 1:309 HAMILTON ST
Practice Address - Street 2:SUITE B
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2181
Practice Address - Country:US
Practice Address - Phone:630-402-0144
Practice Address - Fax:773-442-0421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA41830001A324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility