| NPI | 1750807749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB ROSSER Managing Member 773-236-8566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 071.009553) |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2023-06-26 |