| NPI | 1396014478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARTHUR SCOTT KRAGNESS Supported Living Qsp 773-305-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2011-12-20 |