| NPI | 1427710722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY Z WOULFE Director Of Business Development 847-294-1910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2021-10-13 |
| Last Update Date | 2022-07-19 |