| NPI | 1962123901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN CLUTTER Director Of Finance 847-651-7195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2022-09-08 |