| NPI | 1033867288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DURRELL SHEPPARD Owner 773-450-8043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2022-03-16 |
| Last Update Date | 2026-04-16 |