| NPI | 1881193464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARION MALCOME Owner 312-884-1893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 149.013372) |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2018-02-08 |