| NPI | 1265705990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORENA NAVARRETE Office Manager 708-656-6430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2017-12-07 |