| NPI | 1083316392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATIANA LANE CEO 708-775-2825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2025-07-23 |