| NPI | 1629352695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA JEAN FARLEY Substance Abuse Counselor 708-681-0073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2011-10-07 |