| NPI | 1285385617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORRIE A. GOLDBERG Owner 847-558-1546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2022-01-18 |