| NPI | 1972091080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN ZEIGLER Owner 773-932-5008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149010600) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2019-06-05 |