| NPI | 1780960666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA LOPEZ Manager 847-263-0480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 036.084044) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2011-10-24 |