| NPI | 1386951317 |
|---|---|
| Former Legal Business Name | WEST SUBURBAN TEEN CLINIC |
| Entity Type | Organization |
| Authorized Contact | MEGAN LICHTY Director Of Admin. & Ops. 952-767-0928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2016-12-22 |