NPI | 1245668854 |
---|---|
Entity Type | Organization |
Authorized Contact | PATRICIA OMOROGBE Executive Director 708-418-1608 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IL 201300011C) |
Enumeration Date | 2013-10-16 |
Last Update Date | 2013-10-16 |