| NPI | 1548873888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH ALDANA Administrative Assistant 847-781-4853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2020-08-26 |