| NPI | 1750149308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY J HENRY Licensed Clin Prof Counselor 847-809-5311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-03-08 |
| Last Update Date | 2024-03-08 |