| NPI | 1841626603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARTH AMUNDSON Director 708-930-1833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149005296) |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2013-09-24 |