| NPI | 1205662996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIOTTE GARFIELD LASLEY Owner 312-401-1428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 251S00000X Community/Behavioral Health | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 385HR2065X Respite Care Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2024-09-10 |
| Last Update Date | 2024-09-10 |