| NPI | 1578787644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCISCO CISNEROS Executive Director 773-579-0832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2022-02-07 |