| NPI | 1659842417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE FRUHAUFF Owner 224-408-0019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2019-02-28 |