| NPI | 1326447020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATHEA SMYLES CEO 708-473-7842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103T00000X Psychologist |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2021-09-29 |