| NPI | 1568973709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARA ALTSHULER Authorized Signatory 312-914-0801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2017-10-16 |