| NPI | 1811579030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ANN KRC Clinical Therapist 224-338-6038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2022-09-01 |