| NPI | 1760707947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERI LAUREANO COO 773-239-8940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2021-04-19 |