| NPI | 1477849909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATINA RUSSELL Contract And Cred Specialist 312-663-1130 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: IL A-0538-0044-A) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2021-12-22 |