| NPI | 1417403916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUENTIN CHAMBERS Owner 217-257-0740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G139841) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-08-25 |