| NPI | 1720516099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADEYEMI FATOKI Medical Director 708-862-8156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2019-12-19 |