| NPI | 1174384044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE RIGGINS Owner 708-543-6384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2024-01-18 |
| Last Update Date | 2024-01-18 |