| NPI | 1205652419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENYATTA VAUGHN Executive Director 773-619-7247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-12-03 |
| Last Update Date | 2025-01-07 |