Provider Demographics
NPI:1982688453
Name:ADDICTION TREATMENT SERVICES, INC
Entity type:Organization
Organization Name:ADDICTION TREATMENT SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-346-5223
Mailing Address - Street 1:1010 S GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-3465
Mailing Address - Country:US
Mailing Address - Phone:231-346-5223
Mailing Address - Fax:231-943-2590
Practice Address - Street 1:1010 S GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686
Practice Address - Country:US
Practice Address - Phone:231-346-5216
Practice Address - Fax:231-943-2590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 324500000X
MISA0280085324500000X
MISA0280010324500000X
MISA0280084324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MISA0280088OtherSA LICENSE - PHOENIX
MIGRP300540252Medicaid
MIQMP000005341778Medicaid
MISA0280084OtherSA LICENSE - THE PIER
MICV0023803Medicaid
MIQMP000005341779Medicaid
MISA0280010OtherSA LICENSE - DAKOSKE
MISA0280085OtherSA LICENSE - OUTPATIENT