| NPI | 1497213110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAT BRETT Owner 708-529-0188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2019-03-26 |