| NPI | 1235777244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY MULLANEY Controller 708-236-0979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-12-20 |
| Last Update Date | 2019-12-20 |