| NPI | 1538735238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELIA OWENS Director Of Development And Support 708-747-2655 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2021-06-02 |