| NPI | 1194194175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDA BENJAMIN BASSEY CEO 773-419-2211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: IL 201500006C) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: IL 201500006C) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2015-10-21 |