Provider Demographics
NPI:1396087805
Name:CENTER FOR ALCOHOL AND DRUG TREATMENT, INC.
Entity type:Organization
Organization Name:CENTER FOR ALCOHOL AND DRUG TREATMENT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SILVERNESS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MAM, LADC, LSW
Authorized Official - Phone:218-529-3426
Mailing Address - Street 1:314 W SUPERIOR ST STE 400
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-1892
Mailing Address - Country:US
Mailing Address - Phone:218-529-3434
Mailing Address - Fax:218-529-3440
Practice Address - Street 1:1402 E SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-2430
Practice Address - Country:US
Practice Address - Phone:218-723-8444
Practice Address - Fax:218-529-3441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-22
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder