| NPI | 1912448135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIE TAMURA Therapist 773-401-8699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 180.007566) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2017-03-20 |