| NPI | 1457891764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW WILLIAM HEFFERON President 312-669-4874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 071-008309) |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |