| NPI | 1912890765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA ENGRACIA Manager/Owner 224-420-6482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-05-30 |
| Last Update Date | 2025-09-06 |