Provider Demographics
NPI:1386038859
Name:TREATMENT TRAINING DEVELOPMENTAL SERVICES, LLC
Entity Type:Organization
Organization Name:TREATMENT TRAINING DEVELOPMENTAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:C
Authorized Official - Last Name:REDMOND
Authorized Official - Suffix:SR
Authorized Official - Credentials:PHD
Authorized Official - Phone:312-420-5865
Mailing Address - Street 1:231 W 148TH PL
Mailing Address - Street 2:
Mailing Address - City:DOLTON
Mailing Address - State:IL
Mailing Address - Zip Code:60419-1411
Mailing Address - Country:US
Mailing Address - Phone:312-420-5865
Mailing Address - Fax:
Practice Address - Street 1:1609 SIBLEY BLVD
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-2217
Practice Address - Country:US
Practice Address - Phone:312-716-0534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178009745101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty