Illinois Medicaid- Substance Abuse Kewanee

NPI #1386011161 in Kewanee, Illinois

Provider Information

NPI Number
1386011161
Entity Type
Organization
Organization Name
Illinois Medicaid- Substance Abuse Kewanee
Subpart
Yes (part of a larger organization)
Parent Organization
BRIDGEWAY INC
Primary Specialty
Clinic/Center - Rehabilitation, Substance Use Disorder
Enumeration Date
Aug 27, 2015
Last Updated
Aug 19, 2019

Practice Location

Address
137 E COLLEGE ST
ZIP Code
61443-3703
Phone
(309) 852-4331

Authorized Official

Name
MR. BILL A NELSON, LCPC
Title
CEO
Phone
(309) 344-4200

Specialties & Taxonomy Codes

Specialty
Counselor - Addiction (Substance Use Disorder)Addiction (Substance Use Disorder)
Psychiatry & Neurology - PsychiatryPsychiatry
Psychiatry & Neurology - Child & Adolescent PsychiatryChild & Adolescent Psychiatry
Clinic/Center - MethadoneMethadone
Clinic/Center - Rehabilitation, Substance Use DisorderRehabilitation, Substance Use Disorder

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