| NPI | 1023735164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIAN MEDRANO Therapist 708-990-0796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2022-10-19 |