| NPI | 1417312661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATINA RUSSELL Contract And Cred Specialist 312-663-1130 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2015-12-15 |
| Last Update Date | 2021-12-22 |