Provider Demographics
NPI:1275196917
Name:S.A.C. DUI COUNSELING CENTER, LLC.
Entity Type:Organization
Organization Name:S.A.C. DUI COUNSELING CENTER, LLC.
Other - Org Name:S.A.C. DUI COUNSELING CENTER, LLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MBA, CADC
Authorized Official - Phone:773-891-3653
Mailing Address - Street 1:400 W 76TH ST STE 326
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60620-1696
Mailing Address - Country:US
Mailing Address - Phone:773-891-3653
Mailing Address - Fax:
Practice Address - Street 1:400 W 76TH ST STE 326
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-1696
Practice Address - Country:US
Practice Address - Phone:773-891-3653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No251S00000XAgenciesCommunity/Behavioral Health