| NPI | 1124206032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD E SHELTON Executive Director 773-533-0433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2020-05-21 |