| NPI | 1093884587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE NICHOLAS Office Manager 708-342-1773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-08-22 |