| NPI | 1891359360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLIS GORRIE Director 847-385-5041 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2019-04-30 |