| NPI | 1881922011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLYDE PAYNE Director 708-474-8433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251E00000X Home Health |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2009-11-30 |
| Last Update Date | 2009-11-30 |