Two Rivers Outreach

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

TWO RIVERS OUTREACH

Practice address

401 W Bridge St
Streator, IL 61364-2705

Phone

(815) 220-0299

NPI assigned

Jan 7, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Brian Peter McIntyre, CADC

Title

Business Owner

Phone

(815) 220-0299

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1483747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1427594043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W BRIDGE ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642705",
            "telephone_number": "815-220-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W BRIDGE ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642705",
            "telephone_number": "815-220-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWO RIVERS OUTREACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-07",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A",
        "authorized_official_last_name": "MCINTYRE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "815-220-0299",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "A85410002A",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pamela Travers, PT
• Steven J Trzepacz, O.D.
• U K Sinha, M.D., S.C.
• Jessica Anne Verduzco
• Walgreen Co (Walgreens #03089)
• Jessica Wallbaum
• Walmart Inc.

• Substance Use Disorder Rehabilitation Clinic/Center in Streator, IL
• Providers in Streator, IL by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.