| NPI | 1659687010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLINE ANITA HENDERSON Program Coordinator 708-450-1707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2010-09-08 |