| NPI | 1154538510 |
|---|---|
| Doing Business As | NO |
| Entity Type | Organization |
| Authorized Contact | KATHLEEN SHEA Counselor 815-431-8206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 6878) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180002890) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2025-09-11 |