| NPI | 1861883027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MATT Billing Specialist 312-673-2703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services (Licence: IL 149.015296) |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2021-03-30 |