NPI | 1407381064 |
---|---|
Entity Type | Organization |
Authorized Contact | LAURA LYNN GRIMES Owner 773-659-9207 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149009417) |
Enumeration Date | 2017-04-20 |
Last Update Date | 2020-03-31 |