| NPI | 1144815531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNA FIELDS TYLER Member 708-860-1201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2021-03-08 |