| NPI | 1942534763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAROLD FUENTES Clinical Psychologist 773-636-0846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: IL 071007321) |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2010-05-20 |