| NPI | 1902450315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER WOMACK President 224-306-1879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2019-07-25 |