| NPI | 1760806350 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | EMMITT J MARSHALL Chairperson 773-253-7052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 2278614) |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2014-02-18 |