| NPI | 1114457850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER TABOR Owner/Therapist 815-331-8768 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 060012029) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2017-06-27 |