| NPI | 1295897148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT A SISLER Owner Administrator 847-816-9180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2007-11-27 |