NPI | 1194574020 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES BROWN Credentialing Manager 773-852-7454 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Enumeration Date | 2024-05-14 |
Last Update Date | 2024-05-14 |