| NPI | 1013304781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE ISYANOV Clinical Services Director 847-673-8577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2016-09-03 |