| NPI | 1730861337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA E PETERSON Manager / Owner 312-278-3771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2023-08-02 |
| Last Update Date | 2024-10-04 |