Rodrigo Manjarres in Waukegan - Addiction (substance Use Disorder)
Rodrigo Manjarres - NPI 1376563916
Rodrigo Manjarres is a Addiction (substance Use Disorder) in Waukegan, Illinois. Rodrigo Manjarres practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Rodrigo Manjarres is 1376563916. The last update date is 2007-07-16.
Rodrigo Manjarres's current location address is 3012 Grand Ave, Waukegan, Illinois. You can contact this provider via phone number 8475460080 and fax number 8475460083. The mailing address for Rodrigo Manjarres is 3012 Grand Ave, Waukegan, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Rodrigo Manjarres |
|---|---|
| Address | 3012 Grand Ave, Waukegan, Illinois |
| Phone Number | 8475460080 |
| Fax Number | 8475460083 |
| Sole Proprietor | N |
| Credentials | MA |
NPI Number Detail
| NPI Number | 1376563916 |
|---|---|
| Provider Enumeration Date | 2006-07-19 |
| Last Updated Date | 2007-07-16 |
Provider Mailing Address Detail
| Address | 3012 Grand Ave |
|---|---|
| City | Waukegan |
| State | Illinois (IL) |
| Post Code | 600852321 |
| Phone Number | 8475460080 |
| Fax Number | 8475460083 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
| Licence No | 5176 |
|
Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8008517498 | IL | BLUECROSS BLUESHIELD |
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What is the unique identifier code issued to Rodrigo Manjarres by the Centers for Medicare & Medicaid Services?
The Rodrigo Manjarres has been assigned the NPI (National Provider Identifier) 1376563916. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Rodrigo Manjarres is physically located?
The Rodrigo Manjarres is situated at the following address: 3012 Grand Ave, Waukegan, IL 600852321.
What is the Rodrigo Manjarres's specialty and taxonomy code?
The Rodrigo Manjarres's specialty is Addiction (substance Use Disorder), and the corresponding taxonomy code is 101Ya0400X.
On what date did the Rodrigo Manjarres receive its 1376563916 assignment from the Centers for Medicare & Medicaid Services?
The Rodrigo Manjarres was assigned its 1376563916 by the Centers for Medicare & Medicaid Services on 2006-07-19.
When was the information related to Rodrigo Manjarres most recently updated or refreshed?
The details pertaining to the Rodrigo Manjarres, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-16.
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