| NPI | 1972543551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY PAT O'BRIEN Administrator 773-273-4169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: IL 0028498) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2010-12-10 |