| NPI | 1154894442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA UNGERLEIDER Licensed Clinical Social Worker 847-529-7599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2020-01-07 |