| NPI | 1740815232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCELLA KLAUER Executive Assistant 773-572-5480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2020-03-05 |
| Last Update Date | 2022-07-14 |