| NPI | 1427322213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP A KIRK Owner 815-933-0667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180007481) |
| Enumeration Date | 2012-02-27 |
| Last Update Date | 2012-02-27 |