| NPI | 1326456914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MICHAEL WALSH President 309-794-1097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL A330800003A) |
| Enumeration Date | 2014-07-27 |
| Last Update Date | 2014-07-27 |