| NPI | 1073327169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALDINE S FOX Physician 708-406-9772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-02-06 |
| Last Update Date | 2025-02-13 |