Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction (Substance Use Disorder) |
101YA0400X | |||
Addiction Medicine |
2083A0300X | 84 | Physician/Preventive Medicine | |
Addiction Medicine |
2084A0401X | 79 | Physician/Addiction Medicine | |
Child & Adolescent Psychiatry |
2084P0804X | 86 | Physician/Neuropsychiatry | |
Community/Behavioral Health |
251S00000X | |||
Mental Health |
101YM0800X | |||
Rehabilitation, Substance Use Disorder |
261QR0405X |
| NPI Number | 1710750278 |
| LBN Legal business name | SANDSTONE CARE ILLINOIS, LLC |
| Authorized official | PETER BRINK - (CHIEF FINANCIAL OFFICER) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 11/06/2023 |
| Last updated | 01/30/2024 - About 2 years ago |
| Identifiers | n/a |
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