| NPI | 1881257806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE MICHELLE SHELTON Executive Director 708-654-1361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2020-11-24 |