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PRESENCE BEHAVIORAL HEALTH NPI 1659527208


NPI Information

NPI: 1659527208
Provider Name: PRESENCE BEHAVIORAL HEALTH

Doing Business As: PROCARE CENTERS

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 14D2068105

Address:
355 RIDGE AVE
EVANSTON, IL
ZIP 60202
Phone: (708) 338-3806
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PRESENCE BEHAVIORAL HEALTH is a rehabilitation and substance use disorder clinic center in Evanston, IL. PRESENCE BEHAVIORAL HEALTH NPI is 1659527208. The provider is registered as an organization entity type.
The provider Is Doing Business As Procare Centers.

The provider's business location address is:

355 RIDGE AVE
EVANSTON, IL
ZIP 60202-328
Phone: (708) 338-3806
Fax: (708) 345-5496

The provider's authorized official is Kristin Kaminski .
The authorized official title is Manager, General Accounting and has the following contact phone number (708) 338-3806.

The CLIA number assigned to this NPI record is 14D2068105 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/14/2008 and was last updated on 7/27/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
2261QR0405XClinic/CenterRehabilitation, Substance Use DisorderILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11616027OTHERILLINOISBCBS
2619911MEDICARE PINILLINOIS
3619910MEDICARE PINILLINOIS
4204281MEDICARE PINILLINOIS

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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