| NPI | 1588246607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL B JOHNSON Owner/CEO 773-615-0999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2021-04-27 |