| NPI | 1790287969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON GOEBEL-PAUL Executive Director 847-562-5612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2022-06-22 |