| NPI | 1952274136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA PTAK Owner 815-814-8529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2025-09-24 |
| Last Update Date | 2025-09-24 |