| NPI | 1245093590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARRETT SHOTWELL Owner 773-318-7304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-01-31 |
| Last Update Date | 2024-02-15 |