| NPI | 1205695418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL LAWSON Owner/Manager 815-315-2364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-03-18 |
| Last Update Date | 2024-10-09 |