| NPI | 1023449972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIE N. MARQUEZ CEO 815-977-1425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180-006644) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.008535) |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2013-12-03 |