| NPI | 1770534562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN JEFFERS Executive Director 847-221-7860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IL 012633) |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IL 916003) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2020-02-14 |