| NPI | 1184938730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENTON K JOHNSON President 309-558-9050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180006524) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA 001063) |
| 101YP2500X Counselor, Professional (Licence: IL 180006524) | |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2013-11-30 |