| NPI | 1275092926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDISA JONES Owner 773-559-2290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2022-01-13 |