| NPI | 1689100356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEMLATA VAIDYA Medical Director 708-656-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X (Licence: IL 0360699638) |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2022-02-25 |