| NPI | 1972968568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK PRICE Program Director 773-848-3956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL A-4789-0002-A) |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2015-12-23 |