| NPI | 1265081624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLAFISAYO PEREZ Cco 773-437-5444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2023-12-19 |