| NPI | 1548852072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MARIE ZANON-TOCKE Administrator 773-360-4206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2025-10-15 |