NPI | 1407481401 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNETH G. WIERSUM VP Of Finance 847-441-5603 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2020-03-10 |
Last Update Date | 2020-03-12 |