| NPI | 1700100625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELWOOD P NYTHER COO 773-818-9607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 149004694) |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2010-03-22 |