| NPI | 1316394968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT EVERSON CFO 312-673-2714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2024-09-23 |