| NPI | 1306932751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT EDGER Owner 312-209-1123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 036069216) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2022-07-21 |