| NPI | 1962156109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERENA CAMILLE HOUSTON Owner/Member 773-562-3180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2022-02-07 |
| Last Update Date | 2022-02-07 |