NPI | 1245629088 |
---|---|
Entity Type | Organization |
Authorized Contact | RAUL CASTRO Clinical Director 708-443-4477 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180006165) |
Enumeration Date | 2015-01-16 |
Last Update Date | 2015-01-16 |