| NPI | 1720973084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVISHA FORD Executive Director 708-307-0440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2025-06-09 |
| Last Update Date | 2025-06-09 |