| NPI | 1104439777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MANNO Chief Physician 708-334-8075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2021-12-09 |