MEDMARK TREATMENT CENTERS WOOD RIVER
NPI 1841858404
Clinic/Center - Rehabilitation, Substance Use Disorder in Wood River, IL

Q: What is Southern Illinois Treatment Center, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

Active since May 30, 2019

304 WESLEY DR STE 302306, WOOD RIVER, IL 62095(618) 258-7592 Get Directions Write a Review

NPPES record last updated: July 29, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 29, 2024, Jun 21, 2023, Feb 12, 2021 and 1 more (4 updates tracked since 2019).

On this page

About Medmark Treatment Centers Wood River NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEDMARK TREATMENT CENTERS WOOD RIVER (NPI 1841858404) is a healthcare organization registered as a rehabilitation, substance use disorder in Wood River, Illinois and active in the NPI registry since May 2019. The organization lists Bruce Jarvie, Vp, Treasurer, as its authorized official.

NPPES Registry Identity

NPI1841858404

Entity TypeOrganization

Primary Taxonomy261QR0405X

Legal Business NameSOUTHERN ILLINOIS TREATMENT CENTER, LLC

Location Address304 WESLEY DR STE 302306Wood River, IL 62095-2266

Mailing Address1720 Lakepointe Dr Ste 117Lewisville, TX 75057-6425 · (214) 379-3300

Phone(618) 258-7592

Organization SubpartNo

Authorized OfficialBruce JarvieVp, Treasurer · (214) 379-3300

Enumeration DateMay 30, 2019

Last NPPES UpdateJuly 29, 20244 updates tracked since enumeration

NPPES CertifiedJuly 29, 2024

✔ NPI 1841858404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities

Taxonomy Code261QR0405X

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

Also ListedClinic/Center · MethadoneTaxonomy 261QM2800X

304 WESLEY DR STE 302306, Wood River, IL 62095

Open in Google Maps ↗

Other Names 1

Doing Business AsMedmark Treatment Centers Wood River

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Illinois Treatment Center, LLC's NPI number?

The NPI number for Southern Illinois Treatment Center, LLC is 1841858404. It was assigned to this organization in the NPPES registry on May 30, 2019. The provider is doing business as Medmark Treatment Centers Wood River.

Where is Southern Illinois Treatment Center, LLC located?

Southern Illinois Treatment Center, LLC is located at 304 Wesley Dr Ste 302306, Wood River, IL 62095. The listed phone number is (618) 258-7592.

What is Southern Illinois Treatment Center, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

When was this NPI record last updated?

The NPPES record for Southern Illinois Treatment Center, LLC was last updated on July 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.