| NPI | 1285067611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCO JACOME CEO 773-252-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 12001) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2017-01-06 |