| NPI | 1164075990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN M SELANDER Lcsw 815-520-6972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 251B00000X Case Management | |
| Enumeration Date | 2019-07-21 |
| Last Update Date | 2023-04-20 |