| NPI | 1790373702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JO BAYER Office Manager 773-881-1711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2021-01-05 |