NPIMap

Organization Active NPI

Central East Alcoholism and Drug Council

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Charleston, IL
National Provider Identifier
1174900567
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
A-0631-0005-A Issued in IL
Legal business name
CENTRAL EAST ALCOHOLISM AND DRUG COUNCIL
Practice address
635 Division St FL 3
Charleston, IL 61920-1902
Phone
(217) 348-8108
Fax
(217) 345-6794
NPI assigned
May 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Teressa M. Perdieu, MA CADC
Title
Executive Director
Phone
(217) 348-8108

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X A-0631-0005-A IL Primary

Addresses

Primary practice location

635 Division St FL 3
Charleston, IL 61920-1902

Mailing address

635 Division St
P.O. Box 532
Charleston, IL 61920-1902
Phone (217) 348-8108

Other identifiers 1

IdentifierTypeStateIssuer
CA-0631-0005-AMedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Central East Alcoholism and Drug Council10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

635 Division St
Fl 3
Charleston, IL 61920
Phone (217) 348-8108

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540166400000",
    "number": "1174900567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 DIVISION ST",
            "address_2": "P.O. BOX 532",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619201902",
            "telephone_number": "217-348-8108",
            "fax_number": "217-345-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 DIVISION ST FL 3",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619201902",
            "telephone_number": "217-348-8108",
            "fax_number": "217-345-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL EAST ALCOHOLISM AND DRUG COUNCIL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-05",
        "last_updated": "2018-10-22",
        "status": "A",
        "authorized_official_last_name": "PERDIEU",
        "authorized_official_first_name": "TERESSA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "217-348-8108",
        "authorized_official_credential": "MA CADC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": "A-0631-0005-A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CA-0631-0005-A",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.