| Alcohol & Drug Dependency Services Of Se Iowa | |
|
1340 Mt. Pleasant St Burlington IA 52601 | |
| (317) 753-6567 | |
| (319) 753-0703 |
| Full Name | Alcohol & Drug Dependency Services Of Se Iowa |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 1340 Mt. Pleasant St, Burlington, Iowa |
| Authorized Official Name and Position | Lena Jones (ASSOC. DIRECTOR OF ADMIN) |
| Authorized Official Contact | 3197536567 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alcohol & Drug Dependency Services Of Se Iowa 1340 Mt. Pleasant St Burlington IA 52601 Ph: (317) 753-6567 | Alcohol & Drug Dependency Services Of Se Iowa 1340 Mt. Pleasant St Burlington IA 52601 Ph: (317) 753-6567 |
| NPI Number | 1336721117 |
|---|---|
| Provider Enumeration Date | 04/22/2021 |
| Last Update Date | 04/22/2021 |
| Certification Date | 04/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336721117 | NPI | - | NPPES |
| 0215488 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Primary |
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