NPI | 1063702330 |
---|---|
Entity Type | Organization |
Authorized Contact | ANTHONY OLUJIMI President/CEO 708-297-8580 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X (Licence: IL A-5212-0001-A) |
Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: IL A-5212-0001-A) |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-5212-0001-A) | |
Enumeration Date | 2011-04-07 |
Last Update Date | 2017-12-22 |