| NPI | 1386203917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY HERBOTH Owner 217-259-2827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2019-06-07 |