| NPI | 1437758406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY E TANNER Social Worker 773-430-1075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2020-10-21 |