| NPI | 1851119572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN R HOLTSFORD Owner 630-881-5698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2025-03-24 |