NPI | 1972060929 |
---|---|
Entity Type | Organization |
Authorized Contact | NGONZI CRUSHSHON Owner 312-409-9371 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2019-02-26 |
Last Update Date | 2019-02-26 |