| NPI | 1164040630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE SARAH GOLEM Clinical Social Worker 773-682-6133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2020-07-10 |