| NPI | 1205499951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHAEL SHANNA SYTSMA Owner/President 224-307-4850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2024-03-20 |