| NPI | 1235357849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYN W. JESSUP President 847-501-5897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 071003787) |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2020-08-22 |