| NPI | 1841592615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE MOORE Manager 773-826-3786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2010-11-29 |