| NPI | 1144515156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A SCHREIBER Executive Director 224-306-1879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2013-06-07 |