Provider Demographics
NPI:1104291491
Name:ADDICTION TREATMENT STRATEGIES
Entity type:Organization
Organization Name:ADDICTION TREATMENT STRATEGIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:CRUM
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:618-692-6880
Mailing Address - Street 1:95 N RESEARCH DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-3604
Mailing Address - Country:US
Mailing Address - Phone:618-910-3984
Mailing Address - Fax:
Practice Address - Street 1:95 N RESEARCH DR
Practice Address - Street 2:SUITE 110
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-3604
Practice Address - Country:US
Practice Address - Phone:618-910-3984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180004715251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management