| NPI | 1255616025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK EMMET RUND Supervisor Of Clinical Services 773-382-4615 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2011-10-12 |