| NPI | 1174762348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL K SHANNON Owner 847-867-2265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 166-000370) |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2017-03-09 |