| NPI | 1710042437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL KANTER Controller 773-549-5886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2011-06-29 |