| NPI | 1891486742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JO MACKNISKAS Sr. Director Net Revenue And Reimb 773-213-0776 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit |
| 251S00000X | |
| Enumeration Date | 2023-05-19 |
| Last Update Date | 2023-05-22 |