| NPI | 1679667737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI LYNN CODY Executive Assistant 708-429-1260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2026-06-09 |