| Treatment Training Developmental Services, Llc | |
|
1609 Sibley Blvd Calumet City IL 60409-2217 | |
| (312) 716-0534 | |
| Not Available |
| Full Name | Treatment Training Developmental Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 1609 Sibley Blvd, Calumet City, Illinois |
| Authorized Official Name and Position | Anthony C Redmond (MEMBER) |
| Authorized Official Contact | 3124205865 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Treatment Training Developmental Services, Llc 231 W 148th Pl Dolton IL 60419-1411 Ph: (312) 420-5865 | Treatment Training Developmental Services, Llc 1609 Sibley Blvd Calumet City IL 60409-2217 Ph: (312) 716-0534 |
| NPI Number | 1386038859 |
|---|---|
| Provider Enumeration Date | 03/23/2015 |
| Last Update Date | 03/23/2015 |
| Medicare PECOS PAC ID | 3072833433 |
|---|---|
| Medicare Enrollment ID | O20150526002445 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386038859 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 178009745 (Illinois) | Primary |
| Provider Name | Syreeta L Hughes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396066114 PECOS PAC ID: 7719206697 Enrollment ID: I20150427000541 |
| Provider Name | Kimberly A Alderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760653497 PECOS PAC ID: 4486947009 Enrollment ID: I20160720000221 |
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