| NPI | 1255755096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CRICK Administrator 847-791-4384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2020-06-15 |