| NPI | 1841943495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELIA OWENS Director 708-747-2655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-02-02 |
| Last Update Date | 2022-08-04 |