| NPI | 1356146799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY R. DAGNER Owner 815-994-2190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-02-18 |
| Last Update Date | 2025-02-18 |