| NPI | 1558725150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTON P GLEASON Manager/Owner 773-931-8379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 1962860080) |
| Enumeration Date | 2016-04-09 |
| Last Update Date | 2016-04-09 |