| NPI | 1780428706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS DEL CAMPO EYLER Executive Director 224-858-6933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2024-06-24 |