| NPI | 1003864844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE TIGGES Administrator 773-273-3544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: IL 0029876) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2020-08-22 |