NPI | 1154890721 |
---|---|
Doing Business As | LSSI MADO HEALTHCARE DOUGLAS PARK |
Entity Type | Organization |
Authorized Contact | GREERANN LOVETTE HAMBLET Business Manager 847-390-4422 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2018-11-13 |
Last Update Date | 2018-11-13 |