NPI | 1588087647 |
---|---|
Doing Business As | SOUL SANCTUARY |
Entity Type | Organization |
Authorized Contact | JOSHUA CARL HAMBURG CEO 312-315-3315 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
Enumeration Date | 2014-01-27 |
Last Update Date | 2019-08-29 |