| NPI | 1669488029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCELLA KLAUER Executive Assistant 773-572-5480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2022-07-14 |