| NPI | 1912264540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN LEPSE Director 773-433-5745 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149-001561) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2012-04-20 |