| NPI | 1356890453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER WEEDMAN Cna 618-516-2920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: IL 376K00000X) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2016-09-30 |