| NPI | 1477186492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA ANN MORAN Deputy Chief Centralized Support 847-221-7123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2020-02-18 |