NPI | 1902205222 |
---|---|
Doing Business As | FRESH START |
Entity Type | Organization |
Authorized Contact | CHERYL L BAIRD Therapist 630-234-3961 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: IL 178-000264) |
Enumeration Date | 2014-08-22 |
Last Update Date | 2014-08-22 |