| NPI | 1326809450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACLYN GOLDMAN Member 847-641-0811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-01-16 |
| Last Update Date | 2024-01-16 |