Substance abuse treatment (SAT) facilities offer a number of services for the treatment and ongoing management of substance use disorders, and have emerged as the specialty treatment setting for these disorders. Consistent with established evidence-based practice guidelines, SAT facilities offer several services that address the medical, behavioral, and psychosocial needs of affected individuals. Despite the recommendations from these guidelines, individual facilities differ in terms of the number and type of services offered, resulting in gaps in service availability. This study uses a configuration theory perspective to argue that different classes of SAT facilities may exist based on service mix. The analyses found that SAT facilities systematically differ in the type of services offered. The distinct service profiles identified in this study highlight challenges as well as opportunities for practitioners and policymakers, and also raise several avenues for future research in the area of policy, organizational strategy and substance abuse treatment service delivery.