| NPI | 1124659123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HILARY HARRIS Director 847-599-8902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM2800X Clinic/Center Methadone |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2022-01-19 |