| NPI | 1487993580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY FRANCES FARRELLY Qidp, Qmhp 773-594-0921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 150.010895) |
| Enumeration Date | 2013-02-08 |
| Last Update Date | 2013-02-08 |