| Two Rivers Outreach | |
|
401 W Bridge St Streator IL 61364-2705 | |
| (815) 220-0299 | |
| Not Available |
| Full Name | Two Rivers Outreach |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 401 W Bridge St, Streator, Illinois |
| Authorized Official Name and Position | Brian Peter Mcintyre (BUSINESS OWNER) |
| Authorized Official Contact | 8152200299 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Two Rivers Outreach 401 W Bridge St Streator IL 61364-2705 Ph: (815) 220-0299 | Two Rivers Outreach 401 W Bridge St Streator IL 61364-2705 Ph: (815) 220-0299 |
| NPI Number | 1427594043 |
|---|---|
| Provider Enumeration Date | 01/07/2017 |
| Last Update Date | 12/10/2020 |
| Certification Date | 12/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427594043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | A85410002A (Illinois) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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