| NPI | 1073219044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA MASON Owner 847-868-0126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-02-01 |
| Last Update Date | 2023-03-08 |