| NPI | 1871210351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LONDON-SHIELDS Owner 773-354-4513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0801X |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2022-10-25 |
| Last Update Date | 2022-10-25 |