| NPI | 1225120421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW JON HERITCH President 309-686-1147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-08-22 |