| NPI | 1245830967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE A SPILLNER Executive Assistant To The Cme 224-610-3009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0904X Clinic/Center, Public Health, Federal |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QV0200X Clinic/Center, VA | |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-10-30 |