| NPI | 1528398096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN NOTTAGE Vice President 312-943-6545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A05210015A) |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: IL A05210015A) |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2021-03-12 |