| NPI | 1649655424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRENE MEDINA Owner 773-802-3618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149015712) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180004492) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2015-07-22 |