| NPI | 1205784949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELBY WAYNE PHILLIPS Clinical Social Worker 815-953-0797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2026-03-18 |
| Last Update Date | 2026-03-18 |