| NPI | 1457532343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE LINN BAUER Managing Member 708-848-0491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149009945) |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2008-09-22 |