| NPI | 1407117633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA LEE COTTON-CORNELIUS President 708-386-1253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 180006593) |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2012-06-05 |