| NPI | 1467223404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI LYNN WILMARTH Counselor Mental Health 815-541-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2024-01-09 |
| Last Update Date | 2024-01-09 |