| NPI | 1710344338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BELINDA MORENO VP Finance & Administration 312-808-3218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 332900000X Non-Pharmacy Dispensing Site (Licence: IL A-0584-0004-A) | |
| 332900000X Non-Pharmacy Dispensing Site (Licence: IL A-0584-0002-A) | |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2018-08-10 |