| NPI | 1538522354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TWIN D GREEN President & CEO 708-331-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: IL 15009) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2017-01-09 |