| NPI | 1043046063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ROEDER Social Worker 773-744-3024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-09-09 |
| Last Update Date | 2024-10-29 |