| NPI | 1467994822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JE'SHONA AVERETT Behavioral Support Specialist 773-991-6180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-11-15 |
| Last Update Date | 2016-11-15 |