| NPI | 1255357422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN LESLIE ELLIOTT President 217-398-9066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180003499) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-08-22 |