| NPI | 1588115323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH SMITH Program Manager/Therapist 312-918-9802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2017-06-20 |