| NPI | 1235956723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL MOORE Manager 708-446-9339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-09-25 |
| Last Update Date | 2026-06-09 |