| NPI | 1083884019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYSON EVERETT Executive Director 773-425-8159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: IL A-3249-0001) |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 251S00000X Community/Behavioral Health | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2019-09-30 |