| NPI | 1659840221 |
|---|---|
| Doing Business As | LSSI MADO HEALTHCARE OLD TOWN |
| Entity Type | Organization |
| Authorized Contact | GREERANN LOVETTE HAMBLET Business Manager 847-390-4422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2018-11-13 |