| NPI | 1548013121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON LIPIN Program Director 224-475-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-04-11 |
| Last Update Date | 2024-04-11 |