| NPI | 1245008754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUTUMN GONZALEZ CEO 309-430-8427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2023-12-13 |
| Last Update Date | 2023-12-14 |