| NPI | 1235908070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA COOPER Clinical Director 708-299-2526 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251S00000X | |
| Enumeration Date | 2023-12-21 |
| Last Update Date | 2024-02-27 |