| NPI | 1609222652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE PATRICE KELLY Owner /Director 708-323-8270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2019-06-10 |