| NPI | 1710395918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN NOTTAGE Vice President 312-943-6545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL A-0521-0002-A) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2020-01-29 |