| NPI | 1457866139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW WALL Founder 773-551-7204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 180008228) |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2017-12-04 |