| NPI | 1013532191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA MAUREEN SULLIVAN Director, Clinical Operations 815-347-8258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-06-14 |
| Last Update Date | 2020-06-14 |