| NPI | 1356222848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA A WHITE Therapist 815-291-1841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-09-10 |
| Last Update Date | 2025-10-02 |