| NPI | 1902220353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA SNELTEN Chief Operating Officer 847-546-6450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: IL A-0614-0003) |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2021-04-06 |