| NPI | 1720782659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOPHIA BRACEY Manager 708-668-8589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 251J00000X Nursing Care | |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2023-03-27 |