| NPI | 1912213984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL P KANTER Controller 773-549-1102 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 04040) |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2011-06-28 |