| NPI | 1811618978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELWOOD P NYTHER Administrative/Consultant 773-818-9607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2022-09-07 |