| NPI | 1154647089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERI LYNN LAUREANO Chief Operating Officer 847-284-0430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: IL 012033-11) |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2021-04-19 |