| NPI | 1851283642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN BLACK Executive Director 773-896-7364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-07-17 |
| Last Update Date | 2025-07-17 |