| NPI | 1083093447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE AVALOS Mhp 773-718-1434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: IL 32080000x) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2015-05-19 |