| NPI | 1104947928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA RENE COPELAND President 708-599-4220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 23367) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |