| NPI | 1013747989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH ZIEBA Director Of Contract And Cred 312-502-1816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-08-06 |
| Last Update Date | 2025-02-24 |