| NPI | 1528432432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENZY RICHARDSON Director Of Contract Administration 312-441-9009 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: IL A-0180-0002-A) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2020-08-12 |