NPI | 1003391749 |
---|---|
Entity Type | Organization |
Authorized Contact | JERI LYNN LAUREANO COO 847-284-0430 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2018-09-28 |
Last Update Date | 2021-04-19 |