| NPI | 1629577986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY WILKES CEO 773-536-9922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251B00000X Case Management | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2023-03-25 |