| NPI | 1528500162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN GUADA Owner 847-989-0248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: IL 071.009370) |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2024-02-09 |