| NPI | 1629663281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CRICK Administrator 847-791-4384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2021-03-05 |
| Last Update Date | 2021-03-05 |