NPI | 1043978901 |
---|---|
Entity Type | Organization |
Authorized Contact | STELLA GLADYS BARRUTIA CEO 224-592-5957 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2021-12-07 |
Last Update Date | 2022-01-05 |