| NPI | 1740835149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIA FABIAN Owner 773-945-1437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-08-03 |
| Last Update Date | 2022-03-15 |