| NPI | 1568882504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK AMMER Director Of Clinical Services 847-310-9141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2014-04-17 |