| NPI | 1902377401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY ROBERT LEVY Owner 773-490-2772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-12-09 |
| Last Update Date | 2021-01-25 |