| NPI | 1356816656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM YVETTE JACKSON Owner 708-829-7453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 253J00000X Foster Care Agency |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2018-10-12 |
| Last Update Date | 2023-03-02 |