| NPI | 1417774084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA SOLIS Owner 815-941-3882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2024-09-24 |