Tereo Narcotic Treatment Center, LLC

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

TEREO NARCOTIC TREATMENT CENTER, LLC

Practice address

2405 Northwestern Ave
Suite Lower Level
Racine, WI 53404-2534

Phone

(262) 260-8370

Fax

(262) 260-8538

NPI assigned

Jul 29, 2015

Organization subpart

No

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

Authorized official

Name

Corie Hargrove, BA,CSAC,ICS

Title

Ceo/Owner

Phone

(262) 260-8370

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438905600000",
    "number": "1326423534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 NORTHWESTERN AVE",
            "address_2": "SUITE LOWER LEVEL",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534042534",
            "telephone_number": "262-260-8370",
            "fax_number": "262-260-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 NORTHWESTERN AVE",
            "address_2": "SUITE LOWER LEVEL",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534042534",
            "telephone_number": "262-260-8370",
            "fax_number": "262-260-8538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEREO NARCOTIC TREATMENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-29",
        "last_updated": "2015-08-07",
        "status": "A",
        "authorized_official_last_name": "HARGROVE",
        "authorized_official_first_name": "CORIE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "262-260-8370",
        "authorized_official_credential": "BA,CSAC,ICS"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Talaska, LPN
• Deborah D. Tate, OTR
• John Tate II, APSW
• Darren L Taylor, CSAC
• James H Taylor, MD
• Daniel A Teska, PA-C
• The Littlest Flowers LLC
• The Manna House Adult Family Home
• The W.I.N.G.S Adult Family Home LLC
• The Young Men'S Christian Association of Racine, Wisconsin

• Methadone Clinic in Racine, WI
• Providers in Racine, WI by specialty
• Methadone Clinic in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2015; 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.