| NPI | 1720581101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTUAN DURALL WILBON CEO/Owner 312-474-6189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-07-18 |