| NPI | 1578067237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMIN MARIE WEAVER Clinical Director 773-426-1193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 180009390) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2018-03-19 |