| NPI | 1669701389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY EDWARD HINKELDEY Program Director 847-949-4596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: IL A14580001A) |
| Additional Taxonomies | 251S00000X (Licence: IL A14580001A) |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2011-03-29 |