| NPI | 1164198487 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JAMES CHARLES GRABOWSKI Owner 773-857-0496 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health | 
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health | 
| Enumeration Date | 2021-08-17 | 
| Last Update Date | 2021-09-22 |