| NPI | 1275199846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANITA GROLL President 708-925-3540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-05-19 |
| Last Update Date | 2019-06-07 |