| NPI | 1790371847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM FOMINAYA Executive And Clinical Director 773-234-1463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2024-05-02 |