| NPI | 1164108239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELYSE FELDMANN Insurance Compliance Manager 773-392-6267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-06-23 |
| Last Update Date | 2023-06-23 |