| NPI | 1023852746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANCIE LEVESQUE Co Owner 815-981-2254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2024-06-19 |
| Last Update Date | 2024-06-19 |