| NPI | 1982078903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AL SHOREIBAH CFO 773-572-5262 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X (Licence: IL 04133) |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2019-01-17 |