| NPI | 1770338089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOEL C GREEN Authorized Representative 312-818-0497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy |
| 1041C0700X Social Worker, Clinical | |
| 251B00000X Case Management | |
| Enumeration Date | 2024-04-19 |
| Last Update Date | 2024-04-19 |