| NPI | 1275831216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE CHARLENE FISCHER Owner 847-507-3583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 180006174) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2024-03-20 |