| NPI | 1184022303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL IDOWU KUYE Exec. V/P Of Operations 773-783-3579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-3536-0001-A) |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: IL A-3536-0001-A) |
| Enumeration Date | 2014-12-22 |
| Last Update Date | 2017-07-19 |