| NPI | 1619620853 |
|---|---|
| Other Name | HISTORIC WICKER PARK |
| Entity Type | Organization |
| Authorized Contact | MICHAEL BANGHART Executive Director 773-645-8900 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2022-01-28 |
| Last Update Date | 2022-01-28 |