| NPI | 1265705693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW TRUMAN SHAFFER Licensed Clinical Social Worker 847-730-9738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 149014848) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2012-02-15 |