| NPI | 1285997551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON J IVY Pastoral Counselor 773-241-4861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: GA 02127178) |
| Additional Taxonomies | 251S00000X (Licence: GA 02125023) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2012-06-20 |