NPI | 1962711218 |
---|---|
Other Name | ST. GEORGE |
Entity Type | Organization |
Authorized Contact | NANCY Z WOULFE Director Of Business Development 847-294-1910 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Enumeration Date | 2010-10-05 |
Last Update Date | 2022-07-08 |