| NPI | 1164864302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLEY SMITH Director 847-251-6630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 149013375) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2013-07-29 |