| NPI | 1093088676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE ANN LEONARD President 708-364-7046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: IL 071006856) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: IL 071006856) |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2012-02-13 |