| NPI | 1699265470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN GINGO Owner 312-330-8416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MN 21659) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2018-05-16 |