| NPI | 1093458572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERYL SELENA HEDGLEY Administrator 312-573-2957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2022-10-26 |