| NPI | 1881730620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN MCDONNELL Executive Director 847-492-1778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-0502-009-A) |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: IL A-0502-001-A) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2022-07-21 |