| NPI | 1679294995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH LUPO Director 847-736-7947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2022-09-06 |