| NPI | 1013228717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES JOHN CHRYSTAL Caseworker 4 773-549-5886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 180.004932) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2010-06-28 |