| NPI | 1902982127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY W PEDIGO Secretary Treasurer 708-481-4080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2008-06-07 |