| NPI | 1780487579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCELLA KLAUER Executive Assistant 773-572-5480 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-03-28 |
| Last Update Date | 2025-03-28 |