| NPI | 1083957757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUSTAFA MOYENDA COO 872-221-0041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180-003124) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 14823) |
| 225700000X Massage Therapist (Licence: IL 227013113) | |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2013-08-19 |