| NPI | 1700498573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMONE EDWARDS CFO 773-722-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 251B00000X Case Management | |
| 251S00000X | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2020-08-21 |
| Last Update Date | 2020-08-21 |