| NPI | 1295454171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA I. ZIESAK-SERRANO President 224-308-8534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 251S00000X | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2022-08-24 |