| NPI | 1336695337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE WAHLERT Owner 847-323-4092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180005542) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 19904) |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2024-05-27 |