| NPI | 1679720155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICH BLUE Clinical Director 847-272-3684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 180.001528) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2008-08-26 |