| NPI | 1255699393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE L CHUA President 224-628-6373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0146101) |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2012-04-26 |