| NPI | 1124907852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID STAMPLEY Manager 708-715-4713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-08-27 |
| Last Update Date | 2025-08-27 |