| NPI | 1548774961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRENTICE EARL Executive Director 773-391-3123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2017-11-21 |