| NPI | 1477184406 |
|---|---|
| Other Name | STALEY COUNSELING CENTER |
| Entity Type | Organization |
| Authorized Contact | MICHAEL WARNER CEO 217-423-6961 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2021-05-17 |