| NPI | 1174751663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERI B POWELL Social Worker 217-352-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149013139) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2012-07-17 |