| NPI | 1679229348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE A DYKSTRA Owner 708-549-5616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-02-22 |
| Last Update Date | 2022-02-22 |