| NPI | 1932752904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD THOMPSON Director 312-881-7547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2020-10-01 |