NPI | 1174016877 |
---|---|
Entity Type | Organization |
Authorized Contact | BRANDON ALAN KUTMAS CEO 309-558-0258 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180.011637) |
Enumeration Date | 2018-06-07 |
Last Update Date | 2023-07-09 |