| NPI | 1437884848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MARIE WATERFIELD-COPELAND Owner 847-476-1341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2022-07-19 |