| NPI | 1164475018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAKASHA MCINTOSH Director Of Compliance 773-722-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 002520001) |
| 101YM0800X Counselor, Mental Health (Licence: IL 002520001) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: IL 002520001) | |
| 251S00000X Community/Behavioral Health | |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2024-04-16 |