| NPI | 1699170001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCO E. JACOME Chief Execuitive Officer 773-252-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: IL 12001) |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2023-02-21 |