| NPI | 1881143980 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | MELLONY L GANT President 312-566-1888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2022-07-21 |