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MEDMARK TREATMENT CENTERS SPRINGFIELD
NPI 1871132142
Clinic/Center - Methadone in Springfield, IL

Active since January 03, 2020CLIA 14D2254650 · Waiver
1227 S 9TH ST, SPRINGFIELD, IL 62703(217) 679-1406(217) 679-1545 Get Directions Write a Review

NPPES record last updated: July 29, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 29, 2024, Feb 28, 2023, Feb 12, 2021 and 1 more (4 updates tracked since 2020).

About Medmark Treatment Centers Springfield NPPES

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

MEDMARK TREATMENT CENTERS SPRINGFIELD (NPI 1871132142) is a healthcare organization registered as a methadone in Springfield, Illinois and active in the NPI registry since January 2020. The organization holds a CLIA Waiver certificate valid through March 6, 2028 and lists Bruce Jarvie, Vp, Treasurer, as its authorized official.

NPPES Registry Identity

NPI1871132142
Entity TypeOrganization
Primary Taxonomy261QM2800X
Legal Business NameSPRINGFIELD TREATMENT CENTER, LLC
Location Address1227 S 9TH STSpringfield, IL 62703-2524
Mailing Address1720 Lakepointe Dr Ste 117Lewisville, TX 75057-6425 · (214) 379-3300
Phone(217) 679-1406
Fax(217) 679-1545
Organization SubpartNo
Authorized OfficialBruce JarvieVp, Treasurer · (214) 379-3300
Enumeration DateJanuary 3, 2020
Last NPPES UpdateJuly 29, 20244 updates tracked since enumeration
NPPES CertifiedJuly 29, 2024
✔ NPI 1871132142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities
Taxonomy Code261QM2800X
Definition

An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X
1227 S 9TH ST, Springfield, IL 62703
Open in Google Maps ↗

Other Names 1

Doing Business AsMedmark Treatment Centers Springfield

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2254650

Medmark Treatment Centers Springfield Springfield Treatment Center, LLC · Springfield, IL
Active · expires Mar 6, 2028
CLIA Number14D2254650
Laboratory TypeNarcotic Trmt Program
Certificate Effective DateMarch 7, 2026
Certificate Expiration DateMarch 6, 2028
Laboratory DirectorRichard L. Maenza
Laboratory Phone(217) 858-4340
Laboratory LocationMedmark Treatment Centers Springfield Springfield Treatment Center, LLC1227 S 9th Street, Springfield, IL 62703
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ZARIAH STEELE
Licensed Practical Nurse
1227 S 9TH ST
SPRINGFIELD, IL 62703
Sangamon County (217) 679-1545
JENNIFER ROBERTS LPN
Licensed Practical Nurse
1227 S 9TH ST
SPRINGFIELD, IL 62703
Sangamon County (217) 679-1406
BRYANNA KRISTINE GARDNER MA, CADC
Counselor (Addiction (Substance Use Disorder))
1227 S 9TH ST
SPRINGFIELD, IL 62703
Sangamon County (217) 679-1406
JACKIE RASHELLE MORTON CADC
Counselor (Addiction (Substance Use Disorder))
1227 S 9TH ST
SPRINGFIELD, IL 62703
Sangamon County (217) 679-1406
JOANNE LEE CADC
Counselor (Addiction (Substance Use Disorder))
1227 S 9TH ST
SPRINGFIELD, IL 62703
Sangamon County (217) 679-1406
MR. JAMES ROGER THOMPSON
Counselor
1227 S 9TH ST
SPRINGFIELD, IL 62703
Sangamon County (217) 858-4340

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 Springfield Treatment Center, LLC's NPI number?

The NPI number for Springfield Treatment Center, LLC is 1871132142. It was assigned to this organization in the NPPES registry on January 3, 2020. The provider is doing business as Medmark Treatment Centers Springfield.

Where is Springfield Treatment Center, LLC located?

Springfield Treatment Center, LLC is located at 1227 S 9th St, Springfield, IL 62703. The listed phone number is (217) 679-1406.

What is Springfield Treatment Center, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Methadone, with taxonomy code 261QM2800X.

Does Springfield Treatment Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2254650) is associated with this NPI, valid through March 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Springfield Treatment Center, LLC was last updated on July 29, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.