| NPI | 1346732989 |
|---|---|
| Other Name | CORNELIA |
| Entity Type | Organization |
| Authorized Contact | LINDA A BRUGGEMANN Billing Coordinator 773-506-3201 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 18004) |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2018-08-16 |