| NPI | 1861155400 |
|---|---|
| Former Legal Business Name | ECKER CENTER FORM MENTAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | PAULINE ROCHFORT Billing Director 847-695-0484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2021-10-20 |