| NPI | 1649657719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDDY BORRAYO President/CEO 773-564-9070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: IL 004880004) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2016-10-07 |