| NPI | 1316763873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LIONBERGER Owner 847-691-5323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2024-12-02 |