| NPI | 1972446201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALONIQUE WOODFORK Owner 708-745-2295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2026-04-11 |
| Last Update Date | 2026-04-11 |