| NPI | 1801155080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN BUGAY Clinical Director 773-318-8959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180005135) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149009065) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2012-05-15 |