NPI | 1336635135 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNETH DONNER Owner/Member 847-957-3157 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Enumeration Date | 2018-07-03 |
Last Update Date | 2018-07-03 |