| NPI | 1154071710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE UMOREN Manager 224-595-0112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-03-26 |
| Last Update Date | 2022-03-26 |