| NPI | 1821537739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILES COLE Representative 773-909-2424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: IL c/a-8672-0003-a) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2023-07-25 |