NPI | 1114407830 |
---|---|
Entity Type | Organization |
Authorized Contact | RYANNE R BRIGHT Owner 847-457-6703 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2018-08-21 |
Last Update Date | 2023-03-31 |