| NPI | 1609094788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES R WEISE Executive Director 708-425-3344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IL 92C173) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services (Licence: IL None) |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: IL 0027078) | |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: IL 0035527) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2025-09-11 |