| NPI | 1003315367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAH M JOHNSON Executive Director 708-431-1446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IL 201800003C) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2018-02-01 |