| NPI | 1700583606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUNICE WALKE Director 312-489-4715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center Methadone |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QC1500X Clinic/Center Community Health | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2023-02-10 |
| Last Update Date | 2023-02-10 |