| NPI | 1710609151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM RICHARDSON Administrator 708-595-0973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 101Y00000X Counselor | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2022-09-13 |
| Last Update Date | 2022-09-13 |