| NPI | 1346445871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM DAVID AGOR Owner 630-621-5824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 18.0005579) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2024-03-05 |