| NPI | 1588042931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL M. BOLAND Administrator, President, And CEO 312-655-7460 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 04019) |
| Additional Taxonomies | 251S00000X (Licence: IL 04019) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2023-12-28 |