| NPI | 1578197042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRIS NICHOLE WHITE Owner 773-234-7775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103TC0700X Psychologist Clinical | |
| 261QH0100X Clinic/Center Health Service | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2024-02-23 |