| NPI | 1558690628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA P. HACKBARTH Project Director: Loyola University 708-216-3670 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2009-12-18 |