| NPI | 1316727084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY POTEMPA Manager 708-888-5291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2023-10-02 |
| Last Update Date | 2023-10-02 |