| NPI | 1548012784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATRICE MANUEL Executive Director 773-640-9412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2024-04-02 |
| Last Update Date | 2024-05-13 |