| NPI | 1174013064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA A KOEHLER Therapist 630-360-8416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149007312) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2021-01-30 |