| NPI | 1205326303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA LACKEY Chief Engagement Officer 847-328-7588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180-007-044) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2018-05-14 |