NPI | 1720501646 |
---|---|
Entity Type | Organization |
Authorized Contact | LOUIS V HAYNES Executive Director 773-250-1769 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 180.008602) |
Enumeration Date | 2017-07-23 |
Last Update Date | 2019-08-05 |