| NPI | 1093202558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AL SHOREIBAH CFO 773-572-5262 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2019-01-17 |