| NPI | 1407629066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REED ALLEN Lcpc 815-545-3778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-11-03 |
| Last Update Date | 2023-11-03 |