| NPI | 1205445285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH LANG Business Manager 773-840-8062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2020-07-27 |