| NPI | 1649980947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERED G PRUITT COO 312-328-6606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| 224Z00000X Occupational Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2022-11-29 |
| Last Update Date | 2024-04-02 |