| NPI | 1134568249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN W SLAGLE Owner 815-993-1614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149013269) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2013-06-21 |