| NPI | 1700537743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA BLOOM Owner 847-901-3323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2025-08-04 |