| NPI | 1033636675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE WATZKE JOHNSON Chief Operating Officer 708-671-8199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2018-03-17 |