| NPI | 1407292030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENZY RICHARDSON Director Of Contract Administration 312-441-9009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: IL 04073) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2022-02-15 |