| NPI | 1912206269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER M CLECKNER Owner 312-965-0588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149.011783) |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2011-03-24 |