| NPI | 1134574361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE ISYANOV Clinical Services Director 847-673-8577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| 251B00000X Case Management | |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2022-07-01 |