| NPI | 1114663259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRAN SALBEGO Chief Operating Officer 224-970-1022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2024-08-15 |