| NPI | 1962857193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE ISYANOV Clinical Services Director 847-673-8577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 251B00000X Case Management | |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2018-06-20 |