| NPI | 1285038422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY LEW CLARK President 847-827-9274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2014-10-17 |