| NPI | 1508204330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY KOZAKOWSKI Owner 847-440-3532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: IL 209.010055) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2013-08-27 |