| NPI | 1922345578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENORA ANN MILLER Administrator 708-444-7463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2013-01-15 |