| NPI | 1104489244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REENEE JACKSON Owner 708-743-9090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2020-11-30 |