NPI | 1235796061 |
---|---|
Entity Type | Organization |
Authorized Contact | JENNY LEMUS Licensed Counselor 773-656-2102 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
Enumeration Date | 2019-05-28 |
Last Update Date | 2019-05-28 |