| NPI | 1194031971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER SHANNON Owner 773-850-2295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180007383) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 180007383) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 178005052) | |
| 101YM0800X Counselor, Mental Health (Licence: IL 180007383) | |
| 101YM0800X Counselor, Mental Health (Licence: IL 178005052) | |
| 101YP2500X Counselor, Professional (Licence: IL 178005052) | |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2016-11-02 |