| NPI | 1154141141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES E ALCORN President 708-243-2894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-10-14 |
| Last Update Date | 2024-10-17 |