| NPI | 1114379294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARONSLABA DAVILA Therapist 773-759-7932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149017681) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2016-07-12 |