| NPI | 1063837128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE ISYANOV Clinical Services Director 847-673-8577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X (Licence: IL A-1587-0009-A) | |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2022-07-01 |