| NPI | 1104117316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM EARL HARRIS President/Eo 773-994-8256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL A45570001A) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: IL A45570002A) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2011-10-26 |