| NPI | 1053015297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA MANION FLEMING Member 847-412-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-03-30 |
| Last Update Date | 2023-03-30 |