NPI | 1164108239 |
---|---|
Entity Type | Organization |
Authorized Contact | ALLISON LEIST Administrative Training Specialist 847-412-4387 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2023-06-23 |
Last Update Date | 2024-09-23 |