| NPI | 1982224671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE KULCZYCKI Licensed Clinical Social Worker 847-274-1757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2020-04-22 |