| NPI | 1275004608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN LEANN BARRETTE Director 224-828-9877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 282J00000X Religious Nonmedical Health Care Institution |
| Enumeration Date | 2018-12-11 |
| Last Update Date | 2021-06-14 |