| NPI | 1366082232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA LYNN CERINICH Medical Billing 312-568-7051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2020-01-08 |