| NPI | 1962115857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK DAMON MCCOLLUM CEO 773-746-1399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251T00000X Program of All-Inclusive Care for the Elderly (PACE) Provider Organization |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2023-01-19 |