| NPI | 1982391645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE DZADO Insurance Biller 312-372-6707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-04-21 |
| Last Update Date | 2023-04-21 |