| NPI | 1346640430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE WALTHER Owner 847-354-5977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 180008657) |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2016-09-06 |