| NPI | 1891475448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN HEIDEL Vice President Of Mental Health 773-569-9553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-07-19 |
| Last Update Date | 2023-07-19 |