| NPI | 1245781079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN MARIE TAYLOR Managed Care Superviosr 888-924-3786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: IL A-0126-0010-A) |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2023-03-16 |