| NPI | 1790589364 |
|---|---|
| Former Legal Business Name | NA |
| Entity Type | Organization |
| Authorized Contact | RICARDO WILLIAMS Chief Clinical Officer 708-543-9739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-04-02 |
| Last Update Date | 2025-04-02 |