| NPI | 1992584189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIA WADDELL Director 708-362-1697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 385H00000X Respite Care | |
| 342000000X Transportation Network Company | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 251S00000X Community/Behavioral Health | |
| 385HR2050X Respite Care, Respite Care Camp | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2023-09-26 |
| Last Update Date | 2025-11-17 |