| NPI | 1679960496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE ISYANOV Clinical Services Director 847-673-8577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2018-06-05 |