| NPI | 1962003368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSECA WATSON Credentialing And Contracts Manager 630-572-8228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2020-11-03 |