NPI | 1255115622 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID SCHREIBER Executive Director 224-306-1879 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2023-08-24 |
Last Update Date | 2023-08-24 |