| NPI | 1811774946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVISHA FORD Owner 708-798-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 1041C0700X Social Worker Clinical | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2023-09-12 |