NEW AGE SERVICES CORPORATION NPI 1023286770

NPI Information

NPI: 1023286770
Provider Name: NEW AGE SERVICES CORPORATION
Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

Address:
1330 SOUTH KOSTNER AVE.
CHICAGO, IL
ZIP 60623
Phone: (773) 542-1150
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NEW AGE SERVICES CORPORATION is a methadone clinic center in Chicago, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. NEW AGE SERVICES CORPORATION NPI is 1023286770. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1330 SOUTH KOSTNER AVE.
CHICAGO, IL
ZIP 60623
Phone: (773) 542-1150
Fax: (773) 542-1175

The provider's authorized official is Ulysses Jerome Jefferson .
The authorized official title is Patient Revenue Coordinator and has the following contact phone number (773) 542-1150.

The enumeration date for this NPI number is 2/15/2008 and was last updated on 12/20/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)			No
2	101YM0800X	Counselor	Mental Health			No
3	101YP2500X	Counselor	Professional			No
4	103T00000X	Psychologist				No
5	104100000X	Social Worker				No
6	1041C0700X	Social Worker	Clinical			No
7	207QA0401X	Family Medicine	Addiction Medicine			No
8	2084A0401X	Psychiatry & Neurology	Addiction Medicine			No
9	251S00000X	Community/Behavioral Health		A-0579-0001-A	CALIFORNIA	No
10	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	16008	ILLINOIS	No
11	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	A-0579-001A	ILLINOIS	No
12	276400000X	Rehabilitation, Substance Use Disorder Unit		A-0579-0001-A	ILLINOIS	No
13	261QM2800X	Clinic/Center	Methadone			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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