| NPI | 1104359611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN FARRELL Owner/ Managing Member 773-895-3088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 180.006686) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2017-04-11 |