NPI | 1144577321 |
---|---|
Entity Type | Organization |
Authorized Contact | SHAWN JEFFERS Executive Director 847-221-7860 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IL 012633) |
Enumeration Date | 2012-08-07 |
Last Update Date | 2020-02-14 |