| NPI | 1124890488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD FORGUE Owner 773-445-4784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2023-10-30 |