| NPI | 1952711806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS FERGUSON-COLLUM Counselor 773-654-3875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149015907) |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2014-04-30 |