| NPI | 1780412403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARI MORTENSEN Owner 708-650-4356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2025-02-27 |