| NPI | 1912770363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JISELLE ROMAN Owner 773-531-6241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2023-11-06 |