| NPI | 1306463419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSECA WATSON Contracts And Credentialing Manager 630-572-8228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2020-07-06 |