| NPI | 1710482815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANELL AMARI SMITH Credentialin Specialist 312-663-1130 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2026-08-27 |