| NPI | 1316397979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCAS BYRON SWENINK Owner 773-876-8763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.015898) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150.015780) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2018-11-07 |