| NPI | 1952832727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERRILL D. POWERS Executive Director 312-667-2266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2020-03-05 |